CT fluoroscopy‐guided pancreas transplant biopsies: a retrospective evaluation of predictors of complications and success rates

Abstract

Summary To identify predictors of biopsy success and complications in CT‐guided pancreas transplant (PTX) core biopsy. We retrospectively identified all CT fluoroscopy‐guided PTX biopsies performed at our institution (2000–2017) and included 187 biopsies in 99 patients. Potential predictors related to patient characteristics (age, gender, body mass index (BMI), PTX age, PTX volume) and procedure characteristics (biopsy depth, needle size, access path, number of samples, interventionalist’s experience) were correlated with biopsy success (sufficient tissue for histologic diagnosis) and the occurrence of complications. Biopsy success (72.2%) was more likely to be obtained in men [+25.3% (10.9, 39.7)] and when the intervention was performed by an experienced interventionalist [+27.2% (8.1, 46.2)]. Complications (5.9%) occurred more frequently in patients with higher PTX age [OR: 1.014 (1.002, 1.026)] and when many (3–4) tissue samples were obtained [+8.7% (−2.3, 19.7)]. Multivariable regression analysis confirmed male gender [OR: 3.741 (1.736, 8.059)] and high experience [OR: 2.923 (1.255, 6.808)] (biopsy success) as well as older PTX age [OR: 1.019 (1.002, 1.035)] and obtaining many samples [OR: 4.880 (1.240, 19.203)] (complications) as independent predictors. Our results suggest that CT‐guided PTX biopsy should be performed by an experienced interventionalist to achieve higher success rates, and not more than two tissue samples should be obtained to reduce complications. Caution is in order in patients with older transplants because of higher complication rates.

Different biopsy techniques for different pancreas graft locations after homolateral simultaneous pancreas-kidney transplantation

“…According to the homolateral SPK transplantation method, the latter area was placed toward the anterior abdominal wall, making it a more appropriate puncture point. The advantage of CT combined with ultrasound is that the best puncture point can be determined with CT angiography to avoid the artery ( 3 ), while the splenic vein can be avoided with use of color Doppler when the needle is inserted to the surface of the transplanted pancreatic head, which further ensures safety.…”

“…Because the transplanted pancreas is located in the abdominal cavity, surrounded by the intestinal tract, and often accompanied by adhesions, the risks associated with biopsy are high ( 3 ). However, there are few reports regarding the selection of different biopsy methods.…”