Liver biopsy in liver transplantation: no additional risk of infections in patients with choledochojejunostomy.

Abstract:

BACKGROUND/AIMS:This study aimed to determine whether there is an increased infectious risk following liver biopsy in liver transplant patients with choledochojejunostomy. METHODS:We evaluated the incidence of liver-biopsy-related sepsis in a consecutive series of 27 patients who underwent choledochojejunostomy, either during the transplant procedure (17 patients) or later following biliary complications (10 patients). We evaluated another 138 patients as a control group who had orthotopic liver transplantation during the same period and underwent duct-to-duct anastomosis. All liver biopsies had routine, prior ultrasound evaluation to detect dilated biliary ducts. RESULTS:In the 27 patients who underwent choledochojejunostomy, 96 liver biopsies were performed: the sepsis rate was 3.12% per biopsy (n = 96) or 7.4% per patient (n = 27). However, despite a normal ultrasound, subsequent ERCP demonstrated biliary obstruction in one patient. Thus the rate of sepsis was 2.1% per biopsy or 3.7 per patient. In the control group 338 liver biopsies were performed: the sepsis rate was 1.5% per biopsy (n = 338) or 2.9% per patient (n = 138). The difference was not significant. All septic episodes had positive blood cultures for a single enteric microorganism, and all responded to antibiotics CONCLUSIONS:Our data do not suggest that liver-transplanted patients with choledochojejunostomy are more at risk of sepsis following liver biopsy, providing there is no "occult" biliary obstruction; therefore, they do not require prophylactic antibiotics as has been suggested by other authors.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Ben-Ari Z,Neville L,Rolles K,Davidson B,Burroughs AK

doi

10.1016/s0168-8278(96)80012-2

subject

Has Abstract

pub_date

1996-03-01 00:00:00

pages

324-7

issue

3

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(96)80012-2

journal_volume

24

pub_type

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