Evaluation of ultrasound-assisted Menghini technique in liver graft biopsy

Abstract

Objective: To report on the experience of implementing ultrasound-assisted Menghini technique in the evaluation of liver transplant dysfunction. Methods: Menghini technique uses a suction needle, through percutaneous access, allowing a fast puncture (less than one second), which can help reduce the incidence of complications. Rresults: A total of 87 biopsies performed with 16-gauge suction needles were studied in a period of 15 months. Ultrasound was used to access the presence of perihepatic liquid or collections, biliary and vascular disorders, to mark a safe puncture site and for post-procedure control. The main biopsy indication was elevation of liver enzymes. In 81 cases, one fragment was collected and satisfactory samples were obtained in 85 procedures (97.7%). Minor complications occurred in six patients (6.9%), five with local pain and one with vagal reaction. There was a major complication (1.1%), hemothorax, which was diagnosed by clinical and radiological control examination and then treated. Cconclusions: Menghini technique to obtain liver tissue is quick, effective and safe, but it has always to follow the general care aspects of any intervention procedure. The ultrasound before and after the procedure helps marking an appropriate puncture site, may enhance the effectiveness of the method and is useful to identify possible early complications.

Keywords

• Liver transplantation
• Biopsy
• Needle
• Ultrasonography
• Graft rejection