scholarly journals Blood Transfusion Requirements after Liver Biopsy

2000 ◽  
Vol 14 (10) ◽  
pp. 901-902
Author(s):  
Brian D O’Brien
Keyword(s):  
Blood Transfusion ◽  
Liver Biopsy ◽  
Tertiary Care ◽  
Fatal Outcome ◽  
Health Record ◽  
Percutaneous Liver Biopsy ◽  
Transfusion Requirements ◽  
Risk Patients ◽  
Liver Biopsies ◽  
Record Review

It is common practice to type and screen the blood before performing a percutaneous liver biopsy. Many practitioners think that this is unnecessary but do not have a reason to change their practice. The requirements for transfusion after biopsy were determined in a consecutive sample of cases at a tertiary care teaching hospital with the use of health record review and the anecdotal recall of gastroenterologists and others performing biopsies. One of 266 liver biopsies required a transfusion after biopsy over a two-year period. One other case of hemorrhage with a fatal outcome was recalled by several individuals. It is concluded that the incidence of significant hemorrhage after liver biopsy is low, and that it may not be necessary to type and screen the blood of low risk patients before biopsy.

scholarly journals Percutaneous Liver Biopsy Practice Patterns Among Canadian Hepatologists

2013 ◽  
Vol 27 (11) ◽  
pp. e31-e34 ◽  
Author(s):  
Mohammed Aljawad ◽  
Eric M Yoshida ◽  
Julia Uhanova ◽  
Paul Marotta ◽  
Natasha Chandok
Keyword(s):  
Liver Biopsy ◽  
Patient Preference ◽  
Practice Patterns ◽  
Standard Procedure ◽  
Percutaneous Liver Biopsy ◽  
Equal Frequency ◽  
The Past ◽  
Perception Of Safety ◽  
Liver Biopsies ◽  
Ambulatory Procedure

BACKGROUND: Percutaneous liver biopsy (PLB) is the standard procedure to obtain histological samples essential for the management of various liver diseases. While safe, many hepatologists no longer perform their own PLBs; the reasons for this practice shift are unknown.OBJECTIVE: To describe the attitudes, practice patterns and barriers to PLB among hepatologists in Canada.METHODS: A survey was distributed to all hepatologists in Canada.RESULTS: Thirty-two of 40 (80%) hepatologists completed the survey; the majority of respondents were male (72%) and had been in practice for >5 years in an academic setting. Fifty-six per cent of hepatologists referred all PLBs to radiology, and only 19% of hepatologists reported performing their own PLBs most or all of the time. There were no sex differences nor were there differences based on years in practice. Fifty per cent of respondents who performed PLB routinely used ultrasound, and PLBs are performed in equal frequency in an ambulatory procedure area (50%) versus the endoscopy suite (36%). For almost one-half of hepatologists (47%), their performance of PLBs decreased in the past five years. The majority of respondents at an academic centre (75%) reported access to FibroScan (Echosens, France), and most estimated a resultant 25% to 50% reduction in the need for PLBs. Lack of resources, patient preference and suboptimal reimbursement were the most common reasons cited for not performing PLBs.CONCLUSION: Most hepatologists in Canada do not perform PLBs to the extent that they did in the past, but refer to radiology. The reasons for this shift in practice include lack of resources, improved perception of safety and patient preference. Where available, FibroScan resulted in a perceived 25% to 50% reduction in required liver biopsies.

scholarly journals The Role of Rapid Endoscopy for High-Risk Patients with Acute Nonvariceal Upper Gastrointestinal Bleeding

2007 ◽  
Vol 21 (7) ◽  
pp. 425-429 ◽  
Author(s):  
Laura E Targownik ◽  
Sanjay Murthy ◽  
Leila Keyvani ◽  
Shauna Leeson
Keyword(s):  
High Risk ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Care ◽  
High Risk Patients ◽  
Transfusion Requirements ◽  
Significant Difference ◽  
Risk Patients ◽  
Upper Gastrointestinal

BACKGROUND: Performance of endoscopy within 24 h is recommended for patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB). It is unknown whether performing endoscopy early within this 24 h window is beneficial for clinically high-risk patients.METHODS: A retrospective review was performed to identify patients presenting to two tertiary care centres with ANVUGIB and either systolic blood pressure lower than 100 mmHg or heart rate greater than 100 beats/min on presentation between 1999 and 2004. Patients receiving endoscopy within 6 h (rapid endoscopy [RE]) were compared with patients undergoing endoscopy between 6 h and 24 h (early endoscopy [EE]). The primary outcome measure was the development of any adverse bleeding outcome (rebleeding, surgery for control of bleeding, in-hospital mortality or readmission within 30 days for ANVUGIB).RESULTS: There were 169 patients who met the entry criteria (77 RE patients and 92 EE patients). There was no significant difference in the development of any adverse bleeding outcomes between RE and EE patients (25% RE versus 23% EE, difference between groups 2%, 95% CI −9% to 13%). Transfusion requirements and length of hospital stay also did not differ between the comparator groups. RE was not associated with fewer adverse outcomes, even after adjusting for confounders.CONCLUSION: For clinically high-risk ANVUGIB patients, performing endoscopy within 6 h of presentation is no more effective than performing endoscopy between 6 h and 24 h after presentation. The role of RE in high-risk ANVUGIB patients requires further delineation in a prospective fashion.

scholarly journals Ultrasound-guided percutaneous liver biopsy in children. Five-year experience at a tertiary care center

2021 ◽  
Author(s):  
E. Hernández-Chávez ◽  
M. Alfaro-Hurtado ◽  
C.E. Sánchez-López ◽  
G.A. Badallo-Rivas ◽  
G. Gómez-Navarro ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Percutaneous Liver Biopsy ◽  
Ultrasound Guided

scholarly journals Recipients Perception of Blood Transfusion Risk in Some Selected Tertiary Care Hospitals

2014 ◽  
Vol 5 (2) ◽  
pp. 30-33
Author(s):  
MM Rahman ◽  
TT Sajani
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Large Scale ◽  
Tertiary Care ◽  
Community Based ◽  
Medical College ◽  
Level Of Understanding ◽  
Record Review ◽  
Demographic Condition ◽  
Tertiary Care Hospitals

This was a descriptive study carried out in the Medicine, Surgery, Gynae and Orthopedics ward of three randomly selected tertiary care hospitals at Dhaka, Bogra and Rangpur. It was aimed to evaluate the extent of understanding about the risk of blood transfusion among the blood recipients, to identify the common indications for blood transfusion through record review, to determine the recipients knowledge about indications of blood transfusion, their level of understanding about blood group, blood donors, and risk of blood transfusion and to find out the socio-demographic condition of recipients admitted at tertiary care hospitals. It was found that most of the respondents 63.17% were in the age group of 15-39 years and 56.95% were between primary to secondary level of education. More than half 56.83% respondents were housewife. The idea about indications of blood transfusion was found among 60.37% respondents. The idea about own blood group was found among 73.54% respondents. However, 52.93% respondents were unaware about the persons who can donate blood. Professional blood donor were the choice for own to only 15.60% respondents. The study also identified 57.32% respondents having risk of blood transmissible diseases. The respondents idea about transmissible diseases were identified as AIDs, Hepatitis-B, Syphilis and Malaria by 90.48%, 42.38%, 5.25% and 5.25% respectively. The study demands awareness and motivational program among younger and adult females in regards to transfusion transmissible diseases and its prevention. The importance of knowing blood group,donor selection and adverse effects of transfusion may also considered as a part of awareness program. It also demands a large scale community based survey to generate information towards development of effective strategy in minimizing risk of transfusion transmissible diseases in particular. DOI: http://dx.doi.org/10.3329/akmmcj.v5i2.21129 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 30-33

scholarly journals Value and risk of percutaneous liver biopsy in patients with cirrhosis and clinical suspicion of autoimmune hepatitis

2021 ◽  
Vol 8 (1) ◽  
pp. e000701
Author(s):  
Pimsiri Sripongpun ◽  
Ananya Pongpaibul ◽  
Phunchai Charatcharoenwitthaya
Keyword(s):  
Liver Biopsy ◽  
Autoimmune Hepatitis ◽  
Significant Risk ◽  
Clinical Information ◽  
Diagnostic Information ◽  
Overlap Syndrome ◽  
Clinical Suspicion ◽  
Primary Biliary Cholangitis ◽  
Percutaneous Liver Biopsy ◽  
Liver Biopsies

ObjectiveThe decision regarding whether to perform a liver biopsy in patients with cirrhosis and clinically suspected autoimmune hepatitis (AIH) remains a challenge. This study aimed to assess the utility and complications of percutaneous liver biopsy in cirrhosis for differentiating AIH from other liver conditions.MethodsA clinicopathological database of patients undergoing percutaneous liver biopsies for suspected AIH (unexplained hepatitis with elevated γ-globulin and autoantibody seropositivity) was reviewed to identify patients presenting with cirrhosis. Biopsy slides were reviewed by an experienced hepatopathologist who was blinded to clinical data.ResultsIn 207 patients who underwent liver biopsy for suspected AIH, 59 patients (mean age: 59.0±12.0 years, 83.1% female) had clinically diagnosis of cirrhosis. Mean Child-Turcotte-Pugh score was 6.6±1.6, and 44% of patients had a Child-Turcotte-Pugh score≥7. According to the revised International AIH Group (IAIHG) criteria, histology assessment combined with clinical information facilitated a diagnosis of AIH or overlap syndrome of AIH and primary biliary cholangitis (PBC) in 81.4% of cases. Liver biopsy identified other aetiologies, including PBC (n=2), non-alcoholic steatohepatitis (n=6) and cryptogenic cirrhosis (n=3). A reliable diagnosis of AIH could be made using histological category of the simplified criteria in 69.2% and 81.8% of cases using IAIHG scores before biopsy of <10 and 10–15, respectively. Three patients with cirrhosis (5.1%) experienced bleeding following biopsy, but none of 148 patients with non-cirrhosis had bleeding complication (p=0.022).ConclusionLiver biopsy provides important diagnostic information for the management of patients with cirrhosis and suspected AIH, but the procedure is associated with significant risk.

scholarly journals Clinical Relevance of Transjugular Liver Biopsy in Comparison with Percutaneous and Laparoscopic Liver Biopsy

2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Max G. Beckmann ◽  
Matthias J. Bahr ◽  
Johannes Hadem ◽  
Martin Bredt ◽  
Heiner Wedemeyer ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Clinical Relevance ◽  
Clinical Decision ◽  
Hepatocellular Necrosis ◽  
Transjugular Liver Biopsy ◽  
Risk Patients ◽  
Liver Biopsies ◽  
The Impact

Background. Transjugular liver biopsy (TJLB) is frequently used to obtain liver specimens in high-risk patients. However, TJLB sample size possibly limits their clinical relevance.Methods. 102 patients that underwent TJLB were included. Clinical parameters and outcome of TJLB were analyzed. Control samples consisted of 112 minilaparoscopic liver biopsies (mLLBs) and 100 percutaneous liver biopsies (PLBs).Results. Fewer portal tracts were detected in TJLB (4.3±0.3) in comparison with PLB (11.7±0.5) and mLLB (11.0±0.6). No difference regarding the specification of indeterminate liver disease and staging/grading of chronic hepatitis was observed. In acute liver failure (n=32), a proportion of hepatocellular necrosis beyond 25% was associated with a higher rate of death or liver transplantation.Conclusions. Despite smaller biopsy samples the impact on the clinical decision process was found to be comparable to PLB and mLLB. TJLB represents a helpful tool to determine hepatocellular necrosis rates in patients with acute liver failure.

scholarly journals Serotonin Syndrome in a Patient on Trazodone and Duloxetine Who Received Fentanyl following a Percutaneous Liver Biopsy

2015 ◽  
Vol 9 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Ryan R. Gaffney ◽  
Ian R. Schreibman
Keyword(s):  
Liver Biopsy ◽  
Serotonin Syndrome ◽  
Signs And Symptoms ◽  
Percutaneous Liver Biopsy ◽  
Increased Risk ◽  
Life Threatening ◽  
Sedation And Analgesia ◽  
Missed Diagnosis ◽  
Liver Biopsies ◽  
Medical Intensive Care

Serotonin syndrome is a rare but potentially life-threatening adverse drug reaction resulting from the use or overuse of serotonergic medications alone or in combination. Mild symptoms, overlapping features with similar conditions and clinician lack of awareness are the major reasons for an often missed diagnosis. Not surprisingly, this condition is significantly underreported as a potential complication of endoscopy if serotonergic medications are used periprocedurally for sedation and analgesia. Here we report the case of a patient with relapsed chronic hepatitis C on antidepressant medications who developed signs and symptoms of serotonin syndrome after a percutaneous liver biopsy. Review of the patient's medication list suggested a possible interaction between her home antidepressants and the post-procedure use of fentanyl for abdominal pain. The patient required monitoring in the medical intensive care unit and stabilized after the administration of benzodiazepines and temporary discontinuation of her home medications. We propose that clinicians need to be aware of the increased risk of serotonin syndrome in the outpatient endoscopy setting, particularly with the wider use of serotonergic antidepressants now available and the repeated number of liver biopsies being performed for management of patients with chronic liver disease.

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