A Study on the Safety of Liver Biopsy Inpatients with Von Willebrand’s Disease

Patrick P. Basu^1,2, Niraj J. Shah³, Mark M. Aloysius⁴, K. Rayapudi², Robert Brown²

¹Division of Digestive and Liver Diseases and Center for Liver Disease and Transplantation, Columbia University Medical Center, New York, USA.
²King’s County Hospital Medical Center, New York, USA.
³Liver Transplant Center, University of North Carolina School of Medicine, Carolinas Medical Center, Charlotte, USA.
⁴James J Peters VA Medical Center at Icahn School of Medicine at Mount Sinai, New York, USA.

DOI: 10.4236/ojgas.2015.59022                

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.

Keywords

Liver Biopsy, vW Disease, Safety, Complications

Conflicts of Interest

The authors declare no conflicts of interest.

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