Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Pediatr Gastroenterol Nutr. 2010 Nov;51(5):635-7. doi: 10.1097/MPG.0b013e3181e7e832.
Pediatric liver transplant recipients often need to undergo liver biopsies for the detection and specification of complications such as acute or chronic graft rejection, infection, or drug toxicity. Complications resulting from liver biopsy are rare. The aim of our single-center retrospective study was to report on liver biopsy-related complications and, moreover, to assess the significance of histological findings in correlation with the suspected diagnosis.
Overall, 120 liver biopsies from 67 children were performed and analyzed. All of the biopsies were performed with ultrasound guidance using midazolam and ketamine.
The overall incidence of complications was 5.0%, but most of these complications were mild. In 2 cases, however, the complications were severe and required surgical intervention in addition to further medical treatment.In about 92% of the cases, liver histology confirmed the previously suspected diagnosis based on clinical and clinical laboratory indications.
We concluded that postliver transplantation liver biopsy in children seldom provides unexpected results and, even using ultrasound guidance, has led, albeit rarely, to serious complications. We therefore now accept potential delay in treatment and reserve liver biopsy for patients who fail to respond to therapy based on clinical judgment.
儿科肝移植受者常需进行肝活检以检测和明确并发症，如急性或慢性移植物排斥、感染或药物毒性。肝活检相关并发症罕见。本单中心回顾性研究旨在报告肝活检相关并发症，并评估组织学发现与可疑诊断的相关性的意义。
共对 67 例儿童的 120 次肝活检进行了分析。所有活检均在超声引导下使用咪达唑仑和氯胺酮进行。
总的并发症发生率为 5.0%，但大多数并发症较轻。然而，有 2 例严重，需要除进一步的药物治疗外还需手术干预。约 92%的病例中，肝组织学检查结果证实了基于临床和临床实验室指标的先前可疑诊断。
我们得出结论，儿童肝移植后肝活检很少提供意外结果，即使使用超声引导，也会导致罕见的严重并发症。因此，我们现在接受潜在的治疗延迟，并根据临床判断将肝活检保留给对治疗无反应的患者。
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