The role of transjugular liver biopsy in a liver transplant center

Transjugular liver biopsy is a particularly useful procedure in overcoming the classic limitations of percutaneous biopsy, such as hemorrhagic diathes is or tense ascites. The authors evaluated the impact that this technique h ad in their liver transplant program, considering performance and safety in 160 procedures. Histologic characterization was accomplished in 75% of cir rhotic patients and in 96% of patients with acute liver disease. Confirmati on of a presumptive diagnosis was made in 76% of patients and a previously unsuspected diagnosis was raised in 11%. Hemochromatosis, Wilson's disease, and acute alcoholic hepatitis were the most challenging diagnoses and, tog ether with patients with liver failure, had the most relevant implications in transplant decisions. The availability of transjugular liver biopsy prov ided decisive information regarding patient selection and the best timing t o proceed with transplantation.