Key Points
• Source: Cureus
• Conclusion/Relevance: “The etiology of liver disorders in patients with hematological diseases varies widely. Therefore, histological diagnosis using TJLB [transjugular liver biopsy] is useful to determine an appropriate therapeutic strategy for underlying hematological diseases.”
• In the current study, researchers analyzed the efficacy of TJLB in 27 patients who are not candidates for percutaneous liver biopsy (i.e., hematological disease with liver dysfunction) and developed liver disorders after treatment for hematologic disease.
• Conditions represented in the sample include autoimmune hemolytic anemia, amyloidosis, nonalcoholic steatohepatitis, chronic myelocytic leukemia, ITP, and more.
• “Our results confirmed that TJLB is safe, even for patients with hematological diseases and liver dysfunction. Additionally, tissue sampling using TJLB allowed us to establish a definitive diagnosis in all cases and subsequently formulate an appropriate treatment strategy,” wrote the researchers.
• Previous research has indicated that TJLB and measurement of hepatic venous pressure gradient can be simultaneously performed.
• In the current study, TJLB was indicated for thrombocytopenia, coagulation disorders, ascites, and jaundice
• “While there are no specific contraindications for TJLB, cases with thromboses or other occlusions of the jugular vein, which prevent the catheter from being inserted into the vein, and cases with allergic sensitivity to the contrast medium are generally considered inappropriate for the procedure. Further, TJLB is generally not recommended in cases with lesions in the local region,” wrote the authors.
• The investigators noted no adverse events due to TJLB, but pointed out that adverse events occur in 1.3%-20% of patients, with severe examples including pneumothorax, cervical pseudoaneurysm, and abdominal bleeding. The risk of severe bleeding is % and that for death is 0.02%, which is less than percutaneous liver biopsy.
• Limitations of the current study include its retrospective design and small sample size and that it was challenging to assess the quality of TJLB in all cases of liver disease.