The role of transjugular liver biopsy in a liver transplant center.

Transjugular liver biopsy is a particularly useful procedure in overcoming the classic limitations of percutaneous biopsy, such as hemorrhagic diathesis or tense ascites. The authors evaluated the impact that this technique had in their liver transplant program, considering performance and safety in 160 procedures. Histologic characterization was accomplished in 75% of cirrhotic patients and in 96% of patients with acute liver disease. Confirmation of a presumptive diagnosis was made in 76% of patients and a previously unsuspected diagnosis was raised in 11%. Hemochromatosis, Wilson's disease, and acute alcoholic hepatitis were the most challenging diagnoses and, together with patients with liver failure, had the most relevant implications in transplant decisions. The availability of transjugular liver biopsy provided decisive information regarding patient selection and the best timing to proceed with transplantation.