Nature, timing, and severity of complications from ultrasound-guided percutaneous renal transplant biopsy

Abstract

Summary We sought to review our kidney transplant biopsy experience to assess the incidence, type, presenting symptoms, and timing of renal transplant biopsy complications, as well as determine any modifiable risk factors for postbiopsy complications. This is an observational analysis of patients at the University of Wisconsin between January 1, 2000, and December 31, 2009. Patients with an INR ≥1.5 or platelet counts less than 50 000 were not biopsied. An 18‐gauge needle was used for biopsy. Over the study period, 3738 biopsies were performed with 66 complications (1.8%). No deaths occurred. A total of 0.7% were mild complications, 0.7% were moderate complications, 0.21% were severe complications, and 0.19% were life‐threatening. Most complications occurred within the 4‐h postbiopsy period, although serious complications were often delayed: 67% of complications requiring surgical intervention presented greater than 4 h after biopsy. Biopsy within 1 week of transplant had a 311% increased risk of a complication. Postbiopsy reduction in hematocrit and hemoglobin at 4 h was associated with a complication. In conclusion, life‐threatening complications after renal allograft biopsy occurred in 0.19% of patients. Most complications occurred within 4 h postprocedure; however, many serious complications occurred with a time delay after initially uneventful monitoring. The only clinically significant laboratory predictor of a complication was a fall in the hematocrit or hemoglobin within 4 h. Patients biopsied within a week of transplant were at the highest risk for a complication and should therefore be most closely monitored.

Safety of Outpatient Kidney Biopsies

“…Another similar study of kidney allograft biopsies [25] showed 1.8% of complications, mostly comprising mild complications (0.7%) and only 0.19% life-threatening complications. The difference in the study was that it comprised all allograft biopsies from the institution in- Data is presented as number (percentage), mean ± SD, range.…”

Tangential Extraperitoneal Retrorenal approach: a specified uniform technique for renal transplant biopsy

“…By use of Doppler ultrasound, 12 AVF were detected (4.6%) neither of which required embolization. Our complication rates can be compared to historical data in Table 1 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Sample adequacy could be retrospectively assessed for 156 tissue core samples.…”

Late Rupture of Lumbar Artery as an Unusual Complication after Renal Biopsy - Case Report

“…Specifically it is necessary to instruct the patient about the possible nature of the difficulties and the necessity to immediately contact the respective hospital, if signs of complications occur. This approach could also be applied in the case of a biopsy of transplanted kidney, where a number of late serious bleeding episodes at a time interval up to 2 days after surgery have been reported [9] .…”