Complication Rate of Percutaneous Liver Biopsies among Persons with Advanced Chronic Liver Disease in the HALT-C Trial

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Complication Rate of Percutaneous Liver Biopsies among Persons with Advanced Chronic Liver Disease in the HALT-C Trial

Abstract

BACKGROUND & AIMS:: Although percutaneous liver biopsy is a standard diagnostic procedure, it has drawbacks, including risk of serious complications. It is not known whether persons with advanced chronic liver disease have a greater risk of complications from liver biopsy than patients with more mild, chronic liver disease. The safety and complications of liver biopsy were examined in patients with hepatitis C-related bridging fibrosis or cirrhosis that were enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial. METHODS:: Standard case report forms from 2,740 liver biopsies performed at 10 study sites between 2000 and 2006 were reviewed for serious adverse events, along with information from questionnaires completed by investigators about details of biopsy techniques used at each hospital. RESULTS:: There were 29 serious adverse events (1.1%); the most common was bleeding (16 cases, 0.6%). There were no

biopsy-related deaths. The bleeding rate was higher among patients with platelet counts </=60,000/mm(3) and among those with an international normalized ratio (INR) >/=1.3, although none of the patients with an INR >1.5 bled. Excluding subjects with a platelet count </=60,000/mm(3) would have reduced the bleeding rate by 25% (4/16), eliminating only 2.8% (77/2740) of biopsies. Operator experience, the type of needle used, or the performance of the biopsy under ultrasound guidance did not influence the frequencies of adverse events. CONCLUSIONS:: Approximately 0.5% of persons with hepatitis C and advanced fibrosis experienced potentially serious bleeding after liver biopsy; risk increased significantly in patients with platelet counts </=60,000/mm(3). AGA Institute. Published by Elsevier Inc. All rights reserved.

PMID: 20362695

http://www.ncbi.nlm.nih.gov/pubmed/20362695?dopt=Abstract