Analysis of the indications for liver biopsy in children - experience of pediatric hepatology reference center

Histopathological examination of the liver is used to diagnose, stage, prognose and monitore many liver diseases. Indications to the liver biopsy in children may vary. Percutaneous and surgical biopsies are the most frequently performed procedures in native or in transplanted liver, in explanted and partially resected organs. The aim of this study is to review all of histopathological liver examinations performed in Children's Memorial Health Institute (the main centre of pediatric hepatology in Poland) with division of biopsy types and indications in various age groups.

Methods
The retrospective analysis of biopsies examined in Department of Pathology in 2014 regarding methods of the procedures, indications and age of patients was made.

Results
In 266 patients, 317 tests were performed. In older children (≥ 6 years old, 154), biopsy was used mostly (55.8%) under diagnosis of hepatitis - the most common indication being autoimmune hepatitis (36%). In children < 12 months (47), liver biopsy was necessary in 53.6% cases to determine the cause of cholestasis.

Conclusions
Liver biopsy in children is a common procedure in hepatology. Indications to biopsy vary in particular age groups, the most common being autoimmune hepatitis in older children, focal lesions, indications after liver transplantation and suspicion of biliary atresia (diagnosis of cholestasis) in young infants.