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Transjugular liver biopsy is a safe and effective intervention to guide management for patients with a congenital bleeding disorder infected with hepatitis C

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Abstract

The prevalence of hepatitis C virus (HCV) infection in adult patients with a congenital bleeding disorder (CBD) approaches 95% and is a major cause of morbidity and mortality. Histological examination of the liver remains the cornerstone of management decisions in patients without a CBD. The reluctance to perform liver biopsies in patients with a CBD has been a major limitation in the management of these patients. We are currently the only haemophilia centre in Australasia performing liver biopsies in patients with a CBD for the purpose of guiding prognostic and therapeutic decisions. We report here the results of our centre's experience with transjugular liver biopsy (TJLB) in patients with a CBD. An adequate specimen for histological assessment was attained from all of the patients. There were no major complications recorded. Patients were hospitalized for ≤ 48 h for haemostasis prophylaxis. The diagnostic specimen obtained from patients was integral in guiding their future management. We suggest that with a coordinated multidisciplinary approach, TJLB can be performed in patients with a CBD. (Intern Med J 2005; 35: 556–559)
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Keywords: congenital bleeding disorder; haemophilia; hepatitis C; liver biopsy; transjugular

Document Type: Research Article

Affiliations: 1: Ronald Sawers Haemophilia Centre and Thrombosis Clinic 2: Anatomical Pathology 3: Radiology 4: Gastroenterology, The Alfred, Melbourne, Victoria, Australia

Publication date: 2005-09-01

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