TITLE:
A Study on the Safety of Liver Biopsy Inpatients with Von Willebrand’s Disease
AUTHORS:
Patrick P. Basu, Niraj J. Shah, Mark M. Aloysius, K. Rayapudi, Robert Brown
KEYWORDS:
Liver Biopsy, vW Disease, Safety, Complications
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.5 No.9,
September
24,
2015
ABSTRACT: Objectives: Liver biopsy remains the gold standard for diagnosis of chronic liver diseases. Outpatient percutaneous biopsy is generally safe with a mortality rate of 0.17% and hospitalization rate for bleeding of 3%. Von Willebrand disease (vWD) syndrome is the most common inherited hematological disorder with a prevalence of 1% - 3% globally. We sought to study whether vWD increases the risk of bleeding for liver biopsies. Methods: All patients (n = 120) who underwent outpatient percutaneous liver biopsies from 1997 to 2007 were analyzed. Demographics, PT/INR, platelet count, vW antigen and ristocetin induced platelet aggregation were studied. Results: No vWD patients had major bleeding that required transfusion, hospitalization or surgery but 9 (75%) had minor local bleeding and all had ecchymosis, which resolved spontaneously within 24 hours. Conclusions: Patients with vW factor deficiency can undergo percutaneous liver biopsy without major bleeding. Minor bleeding may occur at a slightly higher rate. vWD is not a contraindication to percutaneous liver biopsy.