Ultrasound-guided Liver Biopsies in Children: A Single-center Experience and Risk Factors for Minor Bleeding

作者:Bilreiro Carlos*; Noruegas Maria J; Goncalves Isabel; Moreira Angela
来源:Journal of Pediatric Gastroenterology and Nutrition, 2017, 65(2): 137-140.
DOI:10.1097/MPG.0000000000001601

摘要

Objectives: The aim of the study was to analyze the institution's experience in ultrasound-guided liver biopsies performed on children and identify risk factors for complications, following a previous study performed in our institution. Methods: Retrospective analysis of a consecutive series of ultrasound-guided pediatric liver biopsies, between 2011 and 2016. Demographic and anthropometric data, biopsy indications, international normalized ratio (INR) and platelet count, biopsy technique, complications, and pathologic outcomes were recorded. Results: A total of 228 procedures were performed on 203 children with a median age of 9.25 years (range: 0.08-18.42): 107 girls (47%) and 121 boys (53%). One hundred twenty-seven biopsies were performed on transplanted livers (55.7%) and 101 on native livers (44.3%). There were 27 cases with immediate complications (11.84%), all due to minor bleeding. There were no major complications. Increasing needle passes were shown to be a reliable predictor for bleeding (P = 0.0023), whereas transplanted livers predicted protection against bleeding (P = 0.0007). Age younger than 3 years, bodyweight <16 kg, platelet count <70 g/L and INR >1.25 revealed association with increased bleeding incidence, but no predictive value. Conclusion: Ultrasound-guided liver biopsies in pediatric age are a safe procedure with a high diagnostic yield. Increasing the number of needle passes predicts a higher incidence of minor bleeding. Other factors to account for minor bleeding risk may include age younger than 3 years, bodyweight <16 kg, platelet count <70 G/L, and INR >1.25. Transplanted livers present a lower bleeding risk.

  • 出版日期2017-8