"Safety and utility of percutaneous liver biopsy in hematopoietic stem cell transplant pediatric recipients: A retrospective study"

Natalia Maximova, Massimo Gregori, Francesca Barbieri, Antonio Pizzol, Aurelio Sonzogni

Research output: Contribution to journalArticle

Abstract

Background: Liver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children. Methods: The study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17.6 %) biopsies were performed in the DSU and 56 (82.3 %) in the BMTU; nine (13.2 %) prior to HSCT and 59 (86.7 %) after HSCT. Pre-procedural behavioral status (subjective score) was evaluated by pediatric transplant physicians by filling in a questionnaire employing a three-point scale: "calm and cooperative", "agitated and non-cooperative" or "frightened and suffering". Objective score was obtained measuring patient's heart rate before the procedure and comparing it with mean heart rate. Results: Patients who underwent the procedure at the BMTU experienced less emotional distress than those who underwent it in the DSU: 58.3 % of patients treated at the DSU were agitated as compared with 16.1 % of those treated at the BMTU (p <0.01). Among the 59 biopsies performed after HSCT, 41 (69.5 %) were taken from symptomatic patients for a diagnostic purpose and 18 (30.5 %) in asymptomatic ones in order to rule out hepatic GVHD. Among these 18 procedures, GVHD was diagnosed in 16 (88.9 %) cases. Minor complications occurred in about 17 % of procedures (12 biopsies), at a rate of 25 % for the DSU location compared with 16 % for the BMTU location. Only two major complications were reported, one in the DSU and one in the BMTU. Conclusion: Liver biopsy performed at bedside in HSCT patients does not carry a higher risk of adverse events than the same procedure performed in the DSU and has lower emotional distress associated with better patient compliance, thus contributing significantly to a higher standard of care.

Original languageEnglish
Article number590
JournalBMC Cancer
Volume16
Issue number1
DOIs
Publication statusPublished - Aug 2 2016

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Hematopoietic Stem Cells
Ambulatory Surgical Procedures
Hematopoietic Stem Cell Transplantation
Retrospective Studies
Pediatrics
Transplants
Biopsy
Safety
Bone Marrow
Liver
Patient Compliance
Heart Rate
Standard of Care
Transplant Recipients
Physicians

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Child emotional distress
  • Liver graft versus host disease
  • Pediatric patients
  • Percutaneous liver biopsy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

"Safety and utility of percutaneous liver biopsy in hematopoietic stem cell transplant pediatric recipients : A retrospective study". / Maximova, Natalia; Gregori, Massimo; Barbieri, Francesca; Pizzol, Antonio; Sonzogni, Aurelio.

In: BMC Cancer, Vol. 16, No. 1, 590, 02.08.2016.

Research output: Contribution to journalArticle

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abstract = "Background: Liver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children. Methods: The study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17.6 {\%}) biopsies were performed in the DSU and 56 (82.3 {\%}) in the BMTU; nine (13.2 {\%}) prior to HSCT and 59 (86.7 {\%}) after HSCT. Pre-procedural behavioral status (subjective score) was evaluated by pediatric transplant physicians by filling in a questionnaire employing a three-point scale: {"}calm and cooperative{"}, {"}agitated and non-cooperative{"} or {"}frightened and suffering{"}. Objective score was obtained measuring patient's heart rate before the procedure and comparing it with mean heart rate. Results: Patients who underwent the procedure at the BMTU experienced less emotional distress than those who underwent it in the DSU: 58.3 {\%} of patients treated at the DSU were agitated as compared with 16.1 {\%} of those treated at the BMTU (p <0.01). Among the 59 biopsies performed after HSCT, 41 (69.5 {\%}) were taken from symptomatic patients for a diagnostic purpose and 18 (30.5 {\%}) in asymptomatic ones in order to rule out hepatic GVHD. Among these 18 procedures, GVHD was diagnosed in 16 (88.9 {\%}) cases. Minor complications occurred in about 17 {\%} of procedures (12 biopsies), at a rate of 25 {\%} for the DSU location compared with 16 {\%} for the BMTU location. Only two major complications were reported, one in the DSU and one in the BMTU. Conclusion: Liver biopsy performed at bedside in HSCT patients does not carry a higher risk of adverse events than the same procedure performed in the DSU and has lower emotional distress associated with better patient compliance, thus contributing significantly to a higher standard of care.",
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AU - Maximova, Natalia

AU - Gregori, Massimo

AU - Barbieri, Francesca

AU - Pizzol, Antonio

AU - Sonzogni, Aurelio

PY - 2016/8/2

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N2 - Background: Liver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children. Methods: The study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17.6 %) biopsies were performed in the DSU and 56 (82.3 %) in the BMTU; nine (13.2 %) prior to HSCT and 59 (86.7 %) after HSCT. Pre-procedural behavioral status (subjective score) was evaluated by pediatric transplant physicians by filling in a questionnaire employing a three-point scale: "calm and cooperative", "agitated and non-cooperative" or "frightened and suffering". Objective score was obtained measuring patient's heart rate before the procedure and comparing it with mean heart rate. Results: Patients who underwent the procedure at the BMTU experienced less emotional distress than those who underwent it in the DSU: 58.3 % of patients treated at the DSU were agitated as compared with 16.1 % of those treated at the BMTU (p <0.01). Among the 59 biopsies performed after HSCT, 41 (69.5 %) were taken from symptomatic patients for a diagnostic purpose and 18 (30.5 %) in asymptomatic ones in order to rule out hepatic GVHD. Among these 18 procedures, GVHD was diagnosed in 16 (88.9 %) cases. Minor complications occurred in about 17 % of procedures (12 biopsies), at a rate of 25 % for the DSU location compared with 16 % for the BMTU location. Only two major complications were reported, one in the DSU and one in the BMTU. Conclusion: Liver biopsy performed at bedside in HSCT patients does not carry a higher risk of adverse events than the same procedure performed in the DSU and has lower emotional distress associated with better patient compliance, thus contributing significantly to a higher standard of care.

AB - Background: Liver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children. Methods: The study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17.6 %) biopsies were performed in the DSU and 56 (82.3 %) in the BMTU; nine (13.2 %) prior to HSCT and 59 (86.7 %) after HSCT. Pre-procedural behavioral status (subjective score) was evaluated by pediatric transplant physicians by filling in a questionnaire employing a three-point scale: "calm and cooperative", "agitated and non-cooperative" or "frightened and suffering". Objective score was obtained measuring patient's heart rate before the procedure and comparing it with mean heart rate. Results: Patients who underwent the procedure at the BMTU experienced less emotional distress than those who underwent it in the DSU: 58.3 % of patients treated at the DSU were agitated as compared with 16.1 % of those treated at the BMTU (p <0.01). Among the 59 biopsies performed after HSCT, 41 (69.5 %) were taken from symptomatic patients for a diagnostic purpose and 18 (30.5 %) in asymptomatic ones in order to rule out hepatic GVHD. Among these 18 procedures, GVHD was diagnosed in 16 (88.9 %) cases. Minor complications occurred in about 17 % of procedures (12 biopsies), at a rate of 25 % for the DSU location compared with 16 % for the BMTU location. Only two major complications were reported, one in the DSU and one in the BMTU. Conclusion: Liver biopsy performed at bedside in HSCT patients does not carry a higher risk of adverse events than the same procedure performed in the DSU and has lower emotional distress associated with better patient compliance, thus contributing significantly to a higher standard of care.

KW - Allogeneic hematopoietic stem cell transplantation

KW - Child emotional distress

KW - Liver graft versus host disease

KW - Pediatric patients

KW - Percutaneous liver biopsy

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