Complications and adequacy of transplant kidney biopsies: A comparison of techniques
| Autor: | Paul D. Killen, Brett Plattner, Michael Heung, Pauline Chen, Matthew Leavitt, Richard Cross |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Image-Guided Biopsy Male medicine.medical_specialty 030232 urology & nephrology Urology Transplant kidney 030230 surgery Kidney Kidney transplant 03 medical and health sciences Postoperative Complications 0302 clinical medicine Predictive Value of Tests Humans Medicine Ultrasonography Interventional Retrospective Studies business.industry Middle Aged Kidney Transplantation Treatment Outcome medicine.anatomical_structure Nephrology Female Kidney Diseases Surgery business |
| Zdroj: | The Journal of Vascular Access. 19:291-296 |
| ISSN: | 1724-6032 1129-7298 |
| DOI: | 10.1177/1129729817747543 |
| Popis: | Introduction: Kidney biopsies are an essential tool in the diagnosis and management of kidney diseases, particularly in kidney transplant recipients. Biopsies carry a risk for serious complications and not all biopsies achieve adequate tissue. We examined the impact of kidney biopsy technique on complications and biopsy adequacy. Methods: The cohort consisted of consecutive kidney transplant patients undergoing biopsy by one of three techniques: ultrasound localization, real-time ultrasound guidance, and ultrasound-guided trocar placement. Variables of interest included patient characteristics and procedural characteristics. The primary outcome was serious complication attributable to kidney biopsy, and the secondary outcome was biopsy adequacy as defined by Banff criteria. Results: Among 263 patients undergoing biopsy, 27 (10.3%) had a complication (14 with gross hematuria, 10 requiring blood transfusion, 3 requiring an unplanned interventional radiology procedure, 1 kidney loss; no deaths). Complications were more common among patients biopsied using ultrasound-guided trocar compared to real-time ultrasound and ultrasound localization (21.4% vs 7.9% vs 7.1%, respectively, p = 0.008). After adjusting for patient and procedure characteristics, technique was no longer significantly associated with complication. Biopsy adequacy was significantly higher when using ultrasound localization and real-time ultrasound compared to ultrasound-guided trocar (84.6% vs 86.8% vs 69.6%, p = 0.029), and this finding persisted in adjusted analysis. Conclusion: Kidney biopsy complications appear to be similar when using any of the three techniques examined in our study. However, ultrasound-guided trocar technique may yield lower biopsy adequacy when compared to non-trocar techniques. |
| Databáze: | OpenAIRE |
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