Ultrasound Guided Liver Biopsy with Gelatin Sponge Pledget Tract Embolization in Infants Weighing Less Than 10 kg.

Purpose: To describe and assess the technical success and safety of ultrasound guided liver biopsy with gelatin sponge pledget tract embolization technique in infants less than 10 kg across three tertiary pediatric hospitals. Materials and Methods: There were 67 pediatric patients weighing less than 10 kg (36 males; 31 females; average age 202 days; average weight 6 kg, range 1.5 kg to 9.9 kg) referred for liver biopsy performed with ultrasound guidance and gelatin sponge pledget tract embolization during a two year period. Patient history, procedural records, and clinical follow-up documents were retrospectively reviewed. Results: A total of 67 procedures were included. There was 100% technical success rate and all samples obtained provided adequate tissue for histological assessment. Average number of 18G biopsy passes was 3 (range 1-6). There were no procedure-related deaths. There was one complication (1%) in an 5 kg infant who was readmitted 36 hours after biopsy with a fever and after antibiotics were administered fully recovered. Biliary atresia was the most common underlying diagnosis (20%), while others included acute rejection (16%), biliary obstruction (7%). Conclusions: Ultrasound guided percutaneous liver biopsy with gelatin sponge pledget tract embolization technique in children less than 10 kg is safe, effective, and use of this technique may lead to a reduction in rates of adverse events reported in other pediatric series. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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