Application of transjugular liver biopsy in pediatric living donor liver transplantation

To evaluate the safety and diagnostic utility of transjugular liver biopsy (TJLB) in pediatric patients with contraindications to percutaneous biopsy after living donor liver transplantation (LDLT). This was a single-center retrospective case series of 22 pediatric LDLT recipients (7 females) who underwent TJLB at Tianjin First Central Hospital between January 2021 and June 2024. Key cohort risks included preoperative coagulation dysfunction (INR > 1.5, n = 9), thrombocytopenia (platelet count < 50 × 10⁹/L, n = 7), and ascites (n = 12). Outcomes analyzed included technical/clinical success rates and postoperative complications. Technical and clinical success rates were both 100% (95% CI: 85.2%–100.0%). No severe complications occurred; only 1 case (4.5%, 95% CI: 0.1%–22.8%) of postoperative abdominal pain (managed with oral analgesics) was reported. All specimens were diagnostically adequate. TJLB demonstrates encouraging safety and diagnostic value in this small single-center cohort of high-risk pediatric LDLT recipients with coagulopathy, thrombocytopenia, or ascites. It provides a reliable alternative for patients with percutaneous biopsy contraindications.