Purpose: To evaluate the efficacy of transjugular liver biopsy(TJLB) in patients who have undergone dual living donor liver transplantation(LDLT) and analyze the necessity of biopsy from dual grafts.Materials: We assessed results from 173 biopsy sessions in 73 patients including 56 TJLB sessions(28 patients),95 percutaneous biopsy sessions,and 22 open biopsy sessions.The TJLB patients had received dual left lobes(n=23),right and left lobes(n=4) and dual left lateral segments(n=1).TJLB samples were taken using a Quick-Core biopsy needle or a biopsy forceps in cases with unfavorable vena cava-hepatic venous angle.We analyzed the technical success rate for TJLB and the consistency of histologic diagnosis based on samples from both grafts according to their CT enhancing patterns.Percutaneous and open biopsy samples were also included in the analysis of the consistency of histologic diagnosis.Results: Except for 23 nontarget grafts,TJLB was successful in 83 of 89(93%) target grafts using a Quick-Core biopsy needle(n=68) or a biopsy forceps(n=15).Liver tissues from 78 of 83(94%) grafts were adequate for histologic diagnosis.Liver tissues of dual grafts were available in 99 sessions,including 27 TJLB sessions.Histologic diagnoses were inconsistent in 21 sessions with consistent(n=14) or inconsistent(n=7) enhancing patterns of dual grafts.The consistency of histologic diagnosis correlated significantly with the enhancing patterns of the dual grafts(p<0.001).Conclusion: TJLB can be used to obtain adequate liver tissue for histologic diagnosis in dual LDLT recipients.Biopsies should be obtained from each graft owing to the possibility of inconsistent histologic diagnoses of dual grafts regardless of enhancing patterns.