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Transjugular Biopsy
Jennifer R. Buckley, MD; Nathan Saucier, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Definitions

              • Transvenous biopsy (TVB): Random (nonfocal) biopsy of liver or kidney via transvenous access
                • Transjugular biopsy: Preferred access via right internal jugular vein due to relatively straight path
                • Transfemoral biopsy: 2nd-line access via femoral vein in cases of central venous occlusion
              • Transvenous hepatic manometry (TVHM): Intrahepatic pressure measurements obtained via transvenous access
                • Free hepatic venous pressure (FHVP): Reflects intraabdominal vena cava pressure, obtained in hepatic vein
                • Wedged hepatic venous pressure (WHVP): Reflects sinusoidal pressure, obtained in hepatic vein via occlusion
                • Hepatic venous pressure gradient (HVPG): Reflects portal perfusion pressure, calculated as WHVP - FHVP
                  • Normal: < 5 mm Hg
                  • Portal Hypertension: > 10 mm Hg

            PREPROCEDURE

            • Indications

              • Contraindications

                • Preprocedure Imaging

                  • Getting Started

                    PROCEDURE

                    • Patient Position/Location

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Things to Do

                              OUTCOMES

                              • Problems

                                • Complications

                                  • Expected Outcomes

                                    Selected References

                                    1. Dohan A et al: Major complications due to transjugular liver biopsy: Incidence, management and outcome. Diagn Interv Imaging. 96(6):571-7, 2015
                                    2. Dohan A et al: Transjugular liver biopsy: indications, technique and results. Diagn Interv Imaging. 95(1):11-5, 2014
                                    3. Li FQ et al: Transfemoral liver biopsy using a Quick-Core biopsy needle system in living donor liver transplantation recipients. Liver Transpl. 20(10):1178-84, 2014
                                    4. Suk KT: Hepatic venous pressure gradient: clinical use in chronic liver disease. Clin Mol Hepatol. 20(1):6-14, 2014
                                    5. Schmid A et al: Transvenous renal transplant biopsy via a transfemoral approach. Am J Transplant. 13(5):1262-71, 2013
                                    6. Jana M et al: Transjugular liver biopsy: tips and tricks. Trop Gastroenterol. 33(3):168-72, 2012
                                    7. Mammen T et al: Transjugular liver biopsy: a retrospective analysis of 601 cases. J Vasc Interv Radiol. 19(3):351-8, 2008
                                    8. Misra S et al: Safety and diagnostic yield of transjugular renal biopsy. J Vasc Interv Radiol. 19(4):546-51, 2008
                                    9. See TC et al: Transjugular renal biopsy: our experience and technical considerations. Cardiovasc Intervent Radiol. 31(5):906-18, 2008
                                    10. Kalambokis G et al: Transjugular liver biopsy--indications, adequacy, quality of specimens, and complications--a systematic review. J Hepatol. 47(2):284-94, 2007
                                    11. Bravo AA et al: Liver biopsy. N Engl J Med. 344(7):495-500, 2001
                                    12. Little AF et al: Transjugular liver biopsy: a prospective study in 43 patients with the Quick-Core biopsy needle. J Vasc Interv Radiol. 7(1):127-31, 1996
                                    13. McAfee JH et al: Transjugular liver biopsy. Hepatology. 15(4):726-32, 1992
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Preprocedure

                                        • Procedure

                                          • Post Procedure

                                            • Outcomes

                                              TERMINOLOGY

                                              • Definitions

                                                • Transvenous biopsy (TVB): Random (nonfocal) biopsy of liver or kidney via transvenous access
                                                  • Transjugular biopsy: Preferred access via right internal jugular vein due to relatively straight path
                                                  • Transfemoral biopsy: 2nd-line access via femoral vein in cases of central venous occlusion
                                                • Transvenous hepatic manometry (TVHM): Intrahepatic pressure measurements obtained via transvenous access
                                                  • Free hepatic venous pressure (FHVP): Reflects intraabdominal vena cava pressure, obtained in hepatic vein
                                                  • Wedged hepatic venous pressure (WHVP): Reflects sinusoidal pressure, obtained in hepatic vein via occlusion
                                                  • Hepatic venous pressure gradient (HVPG): Reflects portal perfusion pressure, calculated as WHVP - FHVP
                                                    • Normal: < 5 mm Hg
                                                    • Portal Hypertension: > 10 mm Hg

                                              PREPROCEDURE

                                              • Indications

                                                • Contraindications

                                                  • Preprocedure Imaging

                                                    • Getting Started

                                                      PROCEDURE

                                                      • Patient Position/Location

                                                        • Procedure Steps

                                                          • Findings and Reporting

                                                            • Alternative Procedures/Therapies

                                                              POST PROCEDURE

                                                              • Things to Do

                                                                OUTCOMES

                                                                • Problems

                                                                  • Complications

                                                                    • Expected Outcomes

                                                                      Selected References

                                                                      1. Dohan A et al: Major complications due to transjugular liver biopsy: Incidence, management and outcome. Diagn Interv Imaging. 96(6):571-7, 2015
                                                                      2. Dohan A et al: Transjugular liver biopsy: indications, technique and results. Diagn Interv Imaging. 95(1):11-5, 2014
                                                                      3. Li FQ et al: Transfemoral liver biopsy using a Quick-Core biopsy needle system in living donor liver transplantation recipients. Liver Transpl. 20(10):1178-84, 2014
                                                                      4. Suk KT: Hepatic venous pressure gradient: clinical use in chronic liver disease. Clin Mol Hepatol. 20(1):6-14, 2014
                                                                      5. Schmid A et al: Transvenous renal transplant biopsy via a transfemoral approach. Am J Transplant. 13(5):1262-71, 2013
                                                                      6. Jana M et al: Transjugular liver biopsy: tips and tricks. Trop Gastroenterol. 33(3):168-72, 2012
                                                                      7. Mammen T et al: Transjugular liver biopsy: a retrospective analysis of 601 cases. J Vasc Interv Radiol. 19(3):351-8, 2008
                                                                      8. Misra S et al: Safety and diagnostic yield of transjugular renal biopsy. J Vasc Interv Radiol. 19(4):546-51, 2008
                                                                      9. See TC et al: Transjugular renal biopsy: our experience and technical considerations. Cardiovasc Intervent Radiol. 31(5):906-18, 2008
                                                                      10. Kalambokis G et al: Transjugular liver biopsy--indications, adequacy, quality of specimens, and complications--a systematic review. J Hepatol. 47(2):284-94, 2007
                                                                      11. Bravo AA et al: Liver biopsy. N Engl J Med. 344(7):495-500, 2001
                                                                      12. Little AF et al: Transjugular liver biopsy: a prospective study in 43 patients with the Quick-Core biopsy needle. J Vasc Interv Radiol. 7(1):127-31, 1996
                                                                      13. McAfee JH et al: Transjugular liver biopsy. Hepatology. 15(4):726-32, 1992