Percutaneous Needle Biopsy of the Transplanted Kidney: Technique and Complications

Huraib, Sameer; Goldberg, Harry; Katz, Ariel; Cardella, Carl J.; Deveber, G.A.; Cook, Gerald T.; Uldall, P. Robert

doi:10.1016/s0272-6386(89)80087-3

Cited by 45 publications

(22 citation statements)

References 9 publications

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“…At present, the etiology of the DGF can only be reliably diagnosed with a kidney biopsy during the first 7-10 days to exclude acute rejection. Kidney biopsies are associated risks of bleeding and possible loss of the allograft (9,10). Some clinicians consider the risk of bleeding to be high during the first 7 days following surgery and advocate avoiding this procedure until after one week.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Detection of Promoter Hypermethylation as a Biomarker of Acute Kidney Injury During Transplantation

Mehta

Hoque

Ugarte

et al. 2006

Transplantation Proceedings

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Aberrant promoter hypermethylation, also known as epigenetics, is thought to be a promising biomarker approach to diagnose malignancies. Kidney repair after injury is a recapitulation of normal morphogenesis, with similarities to malignant transformation. We hypothesized that changes in urine epigenetics could be a biomarker approach during early kidney transplant injury and repair. We examined urine DNA for aberrant methylation of 2 gene promoters (DAPK CALCA) by quantitative methylation specific PCR from 13 deceased and 10 living donor kidney transplant recipients on postoperative day 2 and 65 healthy controls. Results were compared with clinical outcomes and to results of the kidney biopsy. Transplant recipients were significantly more likely to have aberrant hypermethylation of the CALCA gene promoter in urine than healthy controls (100% vs. 31%, p<0.0001). There was increased CALCA hypermethylation in the urine of deceased vs. living donor transplants (21.60 +/− 12.5 vs. 12.19 +/− 4.7 P=0.04). Furthermore, there was a trend towards increased aberrant hypermethylation of urine CALCA in patients with biopsy-proven acute tubular necrosis vs. acute rejection and slow or prompt graft function (mean: 20.40 +/− 6.9, 13.87 +/− 6.49, 17.17 +/− 13.4, P=0.67). However, there was no difference of CALCA hypermethylation in urine of patients with delayed graft function vs. those with slow or prompt graft function (16.9 +/− 6.2 vs. 18.5 +/− 13.7, respectively; P=0.5). There was no aberrant hypermethylation of DAPK in the urine of transplant patients. Urine epigenetics is a promising biomarker approach for acute ischemic injury in transplantation that merits future study.

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Section: Introductionmentioning

confidence: 99%

Quantitative Detection of Promoter Hypermethylation as a Biomarker of Acute Kidney Injury During Transplantation

Mehta

Hoque

Ugarte

et al. 2006

Transplantation Proceedings

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“…4 Risk of perinephric hematoma after transplant kidney biopsy is between 0.7% and 30%. 10,11 Chung and coworkers performed emergency capsulotomy in 4 cases for subcapsular hematomas that developed after transplant graft kidney biopsies. They reported that renal function normalized in 3 cases, but graft loss occurred in 1 case due to acute rejection.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Beyazıt²,

Duymus³

et al. 2017

Exp Clin Transplant

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Subcapsular hematoma after kidney transplant may result in kidney ischemia and graft loss. In this report, we present a patient who had a subcapsular hematoma that had no intraoperative enlargement but ruptured after surgery. A man who had chronic kidney disease secondary to hypertension had a preemptive living-donor kidney transplant from his wife. After declamping, appropriate renal perfusion and urinary output were observed. At perfusion, a subcapsular hematoma (diameter, 3 cm) was observed at the upper pole of the kidney. The hematoma did not enlarge during the surgery. Capsulotomy was not performed due to possible risks, and transplant surgery was completed with the plan for close postoperative ultrasonography and hemodynamic follow-up. Decreased urinary output was observed early after surgery. Renal Doppler ultrasonography showed decreased diastolic flow and a hematoma (width, 9 mm) that completely surrounded the transplanted kidney. The patient had emergency reoperation due to active hemorrhage from his surgical drain at 40 hours after surgery. Rupture of the capsule and hemorrhage from the surface of the kidney were observed. Extended capsulotomy and hemostasis of the kidney were performed. After surgery, urinary flow increased and renal Doppler ultrasonography findings improved. In summary, intervention for a subcapsular hematoma after kidney transplant is controversial. Capsulotomy should be considered for treatment of increased pressure to the graft, risk of permanent damage, and risk of graft loss.

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“…5,15 Although the incidence of APK is about 1% repeat Doppler ultrasonographic examination 5 is a key in nailing the diagnosis and in our centre are carried out by surgical registrars trained by radiologists. Ultrasonography of the graft sometimes can struggle to identify RACS earlier, because even a small haematoma can cause crucial raise in the extraperitoneal pressure ending up in RACS.…”

Section: Discussionmentioning

confidence: 99%

Post-biopsy renal allograft compartment syndrome: Addressing the problem, illustrated with a case report

Thiyagarajan

Bagul

Mohamed

et al. 2011

International Journal of Surgery Case Reports

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Percutaneous Needle Biopsy of the Transplanted Kidney: Technique and Complications

Cited by 45 publications

References 9 publications

Quantitative Detection of Promoter Hypermethylation as a Biomarker of Acute Kidney Injury During Transplantation

Quantitative Detection of Promoter Hypermethylation as a Biomarker of Acute Kidney Injury During Transplantation

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Post-biopsy renal allograft compartment syndrome: Addressing the problem, illustrated with a case report

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