https://www.ncbi.nlm.nih.gov/labs/articles/28394846/

C Bilreiro et al. J Pediatr Gastroenterol Nutr 65 (2), 137-140. 8 2017.

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 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 1.25. Transplanted livers present a lower bleeding risk.