TY - JOUR
T1 - Assessing the risk of hemorrhagic complication following transjugular liver biopsy in bone marrow transplantation recipients
AU - Ahmed, Osman
AU - Ward, Thomas J.
AU - Lungren, Matthew P.
AU - Abdelrazek Mohammed, Mohammed Ahmed
AU - Hofmann, Lawrence V.
AU - Sze, Daniel Y.
AU - Kothary, Nishita
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Purpose To determine if recipients of bone marrow transplants (BMTs) are at increased risk of hemorrhagic complications following transjugular liver biopsy (TJLB). Materials and Methods TJLBs in BMT and non-BMT patients between January 2007 and July 2014 were reviewed. Patient demographic and pre- and postprocedural laboratory data were reviewed. Mean platelet count and International Normalized Ratio were 174,300 × 103/μL ± 107.3 (standard deviation) and 1.2 ± 0.4, respectively, for BMT recipients, compared with 88,100 × 103/μL ± 70.9 and 1.2 ± 0.5, respectively, for non-BMT. Patients in whom hemoglobin level decreased by > 1 g/dL and/or required transfusion within 15 days of TJLB were reviewed to determine the presence of a biopsy-related hemorrhagic complication. Results A total of 1,600 TJLBs in 1,120 patients were analyzed. Of these, 183 TJLBs in 159 BMT recipients and 1,417 TJLBs in 961 patients non-BMT patients were performed. Thirteen TJLBs were complicated by hemorrhage: five in BMT (2.9%) and eight in the non-BMT cohorts (0.6%; P <.01). Preprocedural platelet counts were within normal range (57-268 × 103/μL) in all but one patient (8 × 103/μL). BMT recipients had an odds ratio of 4.9 (95% confidence interval, 1.25-17.3) for post-TJLB bleeding/hemorrhage compared with those without BMTs (P <.01). Conclusions TJLB continues to be a safe procedure in the vast majority of patients. However, hemorrhagic complications occurred at a rate of 2.9% in BMT recipients, compared with 0.6% in patients without BMTs, and therefore caution should be exercised when performing TJLB in this group.
AB - Purpose To determine if recipients of bone marrow transplants (BMTs) are at increased risk of hemorrhagic complications following transjugular liver biopsy (TJLB). Materials and Methods TJLBs in BMT and non-BMT patients between January 2007 and July 2014 were reviewed. Patient demographic and pre- and postprocedural laboratory data were reviewed. Mean platelet count and International Normalized Ratio were 174,300 × 103/μL ± 107.3 (standard deviation) and 1.2 ± 0.4, respectively, for BMT recipients, compared with 88,100 × 103/μL ± 70.9 and 1.2 ± 0.5, respectively, for non-BMT. Patients in whom hemoglobin level decreased by > 1 g/dL and/or required transfusion within 15 days of TJLB were reviewed to determine the presence of a biopsy-related hemorrhagic complication. Results A total of 1,600 TJLBs in 1,120 patients were analyzed. Of these, 183 TJLBs in 159 BMT recipients and 1,417 TJLBs in 961 patients non-BMT patients were performed. Thirteen TJLBs were complicated by hemorrhage: five in BMT (2.9%) and eight in the non-BMT cohorts (0.6%; P <.01). Preprocedural platelet counts were within normal range (57-268 × 103/μL) in all but one patient (8 × 103/μL). BMT recipients had an odds ratio of 4.9 (95% confidence interval, 1.25-17.3) for post-TJLB bleeding/hemorrhage compared with those without BMTs (P <.01). Conclusions TJLB continues to be a safe procedure in the vast majority of patients. However, hemorrhagic complications occurred at a rate of 2.9% in BMT recipients, compared with 0.6% in patients without BMTs, and therefore caution should be exercised when performing TJLB in this group.
UR - http://www.scopus.com/inward/record.url?scp=84961221123&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961221123&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2016.01.007
DO - 10.1016/j.jvir.2016.01.007
M3 - Article
C2 - 26948328
AN - SCOPUS:84961221123
SN - 1051-0443
VL - 27
SP - 551
EP - 557
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 4
ER -