Poster (15W121)

An audit of Liver Biopsies performed at the Department of Hepatology, Cork University Hospital

Author(s)

Ramlaul N, McCarthy K, Crosbie O.

Department(s)/Institutions

Department of Hepatology, Cork University Hospital

Introduction

The aim of this audit was to ascertain the main indications for performing elective day case liver biopsies at our department and compare the findings to a similar audit performed eight years previously, prior to the routine use of Fibroscan.

Aims/Background

A previous audit in 2008 over an 18 month period revealed that most elective liver biopsies carried out in our department were to assess patients with hepatitis C prior to making a decision with regard to the need for antiviral therapy. We wanted to see if there has been a change in practice over this 7 year period.

Method

This is a retrospective study of elective day case liver biopsies performed between January 2014 and April 2015. This excluded patients who were referred to us for care and had a biopsy performed elsewhere or patients having inpatient liver biopsies.

Results

56 elective liver biopsies were performed over a 16 month period (35 female, 21 male), mean age of patients was 50.9 years (range 14 – 78). The commonest indications for proceeding to liver biopsy were to assess and/or diagnose autoimmune hepatitis, steatosis and steatohepatitis, overlap syndromes, the cause of persistent cholestasis and hepatitis C. In 2007-2008, 34% of liver biopsies were performed on patients with hepatitis C whereas now this accounts for only 2 (3.6 %) of the total number. An overwhelming majority of biopsies now performed 29 (51.8%) were to assess autoimmune hepatitis of which 76% were females. The rest of the biopsies showed PBC/overlap syndrome 5 (8.9%), steatosis/steatohepatitis 9 (16.1%), drug induced liver injury 2 (3.6%), chronic hepatitis non-specific 5 (8.9%), cholangitis 2 (3.6%), tumour 1 (1.8%) and normal 1 (1.8%).

Conclusions

This audit clearly illustrates that since the introduction of the Fibroscan, there is rarely a need to perform liver biopsy for the assessment of hepatitis C and thus biopsies were mainly performed to diagnose and assess other conditions which would be more difficult to characterise otherwise.