Feasibility, Efficacy, and Safety of Percutaneous Muscle Biopsies in Patients With Chronic Liver Disease

Frontiers in Physiology

Felicity Williams¹  Amritpal Dhaliwal¹  Ahmed M. Elsharkawy²  Matthew J. Armstrong²  Carolyn A. Greig³  Janet M. Lord³  Leigh Breen³  Sophie L. Allen⁵  Jonathan I. Quinlan⁵ 

[1] Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom;Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom;MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom;NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, Birmingham, United Kingdom;School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom;

关键词: chronic liver disease (CLD);    muscle biopsy;    non-alcoholic fatty liver (NAFLD);    end stage liver disease;    liver disease;   

DOI  :  10.3389/fphys.2021.817152

来源: DOAJ

【 摘 要 】

IntroductionSarcopenia is present in many chronic disease states including decompensated end stage liver disease (ESLD) and non-cirrhotic non-alcoholic fatty liver disease (NAFLD). Sarcopenia in ESLD can negatively impact quality of life and increase mortality. Despite this, very little is understood about the mechanisms of sarcopenia in these conditions. One key reason for this is the reluctance to undertake percutaneous muscle biopsies due to the perceived increased risks. ESLD can induce thrombocytopaenia and coagulopathy which significantly increases the risk of bleeding. In addition, patients with either NAFLD or ESLD often have co-morbidities that would require additional care and risk assessment. Thus, the aim of this study was to establish an effective and safe protocol for the implementation of percutaneous muscle biopsies in patients with NAFLD and ESLD.MethodsA total of 47 patients with ESLD and 9 patients with non-cirrhotic NAFLD were recruited from the Liver Unit, Queen Elizabeth Hospital (Birmingham, United Kingdom). A total of 71 percutaneous vastus lateralis biopsies were attempted over two study visits. A vigorous safety screening occurred prior to and during each visit and a strict protocol was followed to mitigate against complications and risk.ResultsA total of 85% of patients consented to the muscle biopsy at either visit (48/56). A total of 9% of consented biopsies could not occur due to medical considerations, including high international normalised ratio (INR) (n = 3) and the use of aspirin (n = 4). Muscle tissue was obtained from 90% of attempts, with a mean average yield (wet weight tissue) of 98.1 ± 52.9 mg.ConclusionPercutaneous muscle biopsies are both feasible and yield sufficient tissue in an ESLD population. The procedure is effective for obtaining muscle tissue whilst also safe, with only one adverse event. This study provides evidence for the successful use of muscle biopsies in this population, even in consideration of disease specific complications, medications, and comorbidities.

【 授权许可】

Unknown