Percutaneous Ultrasound-Guided Kidney Transplant Biopsy Outcomes: From the Nephrologist to the Radiologist Standpoint. Issue 10 (27th October 2022)

• Record Type: Journal Article
• Authors: Mattiazzi, Adela D.; Cortesi, Camilo A.; Patil, Rhea J.; Carias Martinez, Karla G.; Sedki, Mai; Cabeza Rivera, Franco H.; Ruiz, Phillip; Salsamendi, Jason T.; Guerra, Giselle
• Is Part Of: Kidney360. Volume 3:Issue 10(2022)
• Page Start: 1746
• Page End: 1753
• Publication Date: 2022-10-27
• Subjects: transplantation -- biopsy complications -- interventional radiology -- interventional ultrasonography -- kidney biopsy -- transplant nephrology; 616.61
• DOI: 10.34067/KID.0000332022
• Languages: English
• ISSNs: 2641-7650

Abstract

Key Points: Ultrasound-guided kidney transplant biopsy is considered safe, with similar complications rates regardless of the performing team. Besides well-known risk factors for complications, we found that sex and race are also predictors. The performance of kidney transplant biopsy remains an integral part of nephrology training. Visual Abstract: Abstract : Background: Kidney transplant biopsies are the gold standard for evaluating allograft dysfunction. These biopsies are performed by nephrologists and radiologists under real-time ultrasound guidance. A few studies have examined the outcomes of ultrasound-guided kidney transplant biopsy in transplant recipients; however, none have compared these outcomes between both specialties. Methods: We retrospectively analyzed a cohort of 678 biopsies performed in a single center during a 44-month study period. Biopsies were stratified into two groups based upon the specialist performing the procedure: interventional radiology (IR; N =447) and transplant nephrology (TN; N =231). Results: There were 55 (8%) complications related to biopsies in the entire cohort: 37 (8.2%) in the IR group and 18 (7.7%) in the TN group, without statistical difference between the groups ( P =0.94). Blood pressure control and prior use of anticoagulation were significant predictors of complicated biopsies ( P =0.004 and 0.02, respectively). Being a woman and prior use of anticoagulation were significant predictors of transfusion of blood products ( P =0.01 and 0.01, respectively). Being a woman and blood pressure control were significant predictors of overall perinephric hematoma ( P =0.01 and 0.01, respectively), and Black race was a significant predictor of perinephric hematoma without worsening of renal function ( P =0.005). The specialist team performing the procedure was not a statistically significant predictor of biopsy complications, transfusion of blood products, or perinephric hematoma with comparable sample yield. Conclusions: Percutaneous ultrasound-guided kidney transplant biopsy performed by transplant nephrologists have similar complication rates when compared with interventional radiologists in an academic center.