Percutaneous Transplant Liver Biopsies: Does Biopsy Needle Gauge Matter?

TL;DR

This study found that using larger biopsy needles (17/18G) in liver transplants leads to better sample quality than smaller ones (19/20G), with low complication rates.

Contribution

The study provides evidence on the impact of biopsy needle gauge on sample adequacy in liver transplant biopsies.

Findings

17/18G needles had significantly fewer inadequate samples compared to 19/20G needles.

The complication rate was low, with only one clinically significant bleeding event.

No significant difference was found in the number of cores taken between the two needle sizes.

Abstract

Introduction

This study evaluates coaxial core needle size (17/18G vs 19/20G) and sample adequacy in liver transplant biopsies.

Materials and methods

This was an Institutional Review Board (IRB)-approved retrospective study of 397 percutaneous transplant liver biopsies performed over four years with 17G/18G or 19G/20G coaxial and core needles. Medical records were reviewed for needle size, number of cores, tract embolization, complications, and sample adequacy by pathology. Statistical significance was determined using a combination of t-tests and chi-squared tests with a significance level less than 0.05.

Results

There were 257 18G core biopsies and 140 20G biopsies. Sample inadequacy was noted in 3/257 of the 18G biopsies and 19/140 of the 20G biopsies (p<0.0001). The mean number of cores taken was 3.17±0.72 and 3.06±0.81 for 18G and 20G biopsies, respectively (p=0.14). There was no significant difference between the two groups regarding the number of cores taken in the adequate or inadequate samples. Tract embolization was performed in 353/397 biopsies. One clinically significant bleeding complication was noted in a procedure done with a 20G needle with two core biopsies. No other major complications were noted.

Conclusion

Random transplant liver biopsies performed with coaxial 17G/18G core biopsy needles are more likely to provide adequate results than biopsies performed with 19G/20G needles. The risk of complications in transplant liver biopsies is low.