Clinical impact of liver biopsies in liver transplant recipients

Background: Percutaneous liver biopsy is an established diagnostic procedure for the assessment of liver pathologies. Limited data are available on the clinical impact of liver biopsies in liver transplant recipients. Material/Methods: Liver transplant recipients undergoing liver biopsy between 2000 and 2013 were analyzed. Demographic characteristics and transplantation data were extracted from the transplantation database. Results: A total of 496 liver biopsies were performed in 312 patients. The main biopsy indications were suspected rejection (66%, 327/496), protocol biopsy (22%, 108/496), and suspected recurrence of the primary disease (7%, 34/496). Histological findings showed acute cellular rejection in 36% (179/496), idiopathic chronic hepatitis in 28% (141/496), and normal histology in 11% (54/496). Liver biopsies in patients with clinically suspected rejection showed histological findings compatible with acute or chronic rejection in 46% (151/327). In 41% (205/496) of the patients, the immunosuppressive therapy was adjusted due to the biopsy result. For alanineaminotransferase and bilirubin, significant differences were detected between baseline and week 4 and 12 after treatment modification (p<0.05). Conclusions: Liver biopsies in liver transplant recipients have potential impact on the modification of the immunosuppressive therapy. The correlation between suspected rejection and histological findings is limited; therefore, a liver biopsy is indicated in unclear cases.