Liver biopsy in liver patients with coagulopathy

The risk of severe bleeding after liver biopsy is estimated to be 1:12,000 in patients with near normal coagulation (INR < 1,5 and platelet count > 60 billion /l). Beyond these limits, the risk is higher, but still uncertain. The Danish guidelines require INR > 1.5, platelet count < 40 b...

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Bibliographic Details
Published inUgeskrift for læger Vol. 170; no. 45; p. 3671
Main Authors Ott, Peter, Grønbaek, Henning, Clemmesen, Jens Otto, Clausen, Mette Rye, Wettergren, André, Havelund, Troels, Feldager, Erik, Bendtsen, Flemming, Hansen, Bent Adel, Tage-Jensen, Ulrik, Larsen, Lars Peter, Vilstrup, Hendrik
Format Journal Article
LanguageDanish
Published Denmark 03.11.2008
Subjects
Biopsy - adverse effects
Blood Coagulation Disorders - complications
Blood Coagulation Disorders - pathology
Contraindications
Hemorrhage - etiology
Hemorrhage - prevention & control
Humans
International Normalized Ratio
Liver - pathology
Liver Diseases - complications
Liver Diseases - pathology
Platelet Count
Risk Factors
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Summary:The risk of severe bleeding after liver biopsy is estimated to be 1:12,000 in patients with near normal coagulation (INR < 1,5 and platelet count > 60 billion /l). Beyond these limits, the risk is higher, but still uncertain. The Danish guidelines require INR > 1.5, platelet count < 40 billion /l and normal APTT. In some instances the risk of not knowing the histology is so high that a biopsy is considered even with a more disturbed coagulation. Vitamin K, freshly frozen plasma and recombinant activated factor VII may reduce the risk of bleeding in specific situations, but no firm recommendations can be given.
ISSN:1603-6824