Significance and safety of renal allograft biopsies: Experience from a tertiary care center in India

Gaur, Nisha; Malhotra, Vinay; Agrawal, D. P.; Singh, Shailendra Kumar; Beniwal, Pankaj; Sharma, Sanjeev Kumar; Jhorawat, Rajesh; Joshi, Parvati; Khandelwal, Shikha; Gupta, Vartul

doi:10.4103/ijot.ijot_10_19

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…After the removal of duplicates, 5004 unique records were identified, of which 4814 records were excluded after the screening of titles and abstracts. Of the 190 remaining studies, 72 studies (40 082 biopsies) 2,3,9,14,25-92 were included in the systematic review and meta-analysis after full-text review (Figure 1) including 4 single-center randomized controlled trials, 3 multicenter cohort studies (1 mixed retrospective-prospective and 2 retrospective), and 65 single-center cohort studies (10 prospective, 1 mixed retrospective-prospective, 46 retrospective, and 8 unreported). Details of the included studies are presented in Table S1, SDC, http://links.lww.com/TP/C332.…”

Section: Resultsmentioning

confidence: 99%

Complications of Percutaneous Kidney Allograft Biopsy: Systematic Review and Meta-analysis

Lim

Tan

et al. 2022

Transplantation

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Background. Kidney biopsy is important to guide the management of allograft dysfunction but has a risk of complications. This review aimed to determine the incidence and risk factors of complications after kidney allograft biopsy. Methods. This is a systematic review and meta-analysis of randomized controlled trials, cohort studies, or case-control studies indexed on PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry, and ClinicalTrials.gov, limited to the English language, from January 2000 to December 2020, including adult and pediatric kidney allograft biopsies. Primary outcomes were gross hematuria, bleeding requiring transfusion, and major complications (requiring interventions such as blood transfusion or surgical or radiological interventions). Results. The review included 72 studies (40 082 biopsies). The quality of included studies was suboptimal. Pooled rates of gross hematuria, bleeding requiring transfusion, and major complications were 3.18% [95% confidence interval (95% CI), 2.31-4.19], 0.31% (95% CI, 0.15-0.52) and 0.89% (95% CI, 0.61-1.22), respectively. Gross hematuria rates were lower in high-income compared with middle-income countries (2.59% versus 6.44%, P < 0.01) and biopsies performed by radiology as compared with nephrology departments (1.25% versus 3.71%, P < 0.01). Blood transfusion rates were lower in pediatrics than adults (0.0% versus 0.65%, P < 0.01). Major complications were lower in biopsies performed by specialists as compared with trainees (0.02% versus 3.64%, P < 0.01). Graft loss and mortality were extremely rare. Limitations included missing data, few randomized controlled trials, and possible publication bias. Conclusions. The risk of complications after kidney allograft biopsy was low. Given the low quality of included studies, risk factors for complications should be further examined in future studies.

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