Computed tomography-guided kidney transplant biopsy outcomes: A single-center experience

Camilo Cortesi, Mai Sedki, Phillip Ruiz, Jason Salsamendi, Adela Mattiazzi

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Percutaneous kidney transplant biopsy is typically performed using ultrasonographic guidance; computed tomography is an alternative modality used to obtain kidney allograft tissue when ultrasonography-guided percutaneous kidney transplant biopsy is technically challenging. Studies examining postbiopsy outcomes in kidney transplant patients using a computed tomography-guided approach are scarce. Our goal was to report the incidence of nonsevere and severe complications in computed tomography-guided percutaneous kidney transplant biopsies and the potential risk factors. Materials and Methods: We retrospectively reviewed computed tomography-guided percutaneous kidney transplant biopsies in patients undergoing work-up for kidney allograft rejection between 2013 and 2017. Demographics, comorbidities, laboratory data, history of antiplatelet and/or anticoagulant use, and com-plications were assessed. Results: During the study period, 28 patients underwent computed tomography-guided percutaneous kidney transplant biopsies; mean age was 57.5 ± 15.5 years, and 12 (43%) were women. Twenty-three patients (82%) were obese, with a body mass index greater than 30 kg/m2. Our cohort of kidney transplant recipients included 21 (75%) from deceased donors and 7 (25%) from living-related donors. At the time of biopsy, 6 patients (21%) had elevated blood pressure (defined as > 160/90 mm Hg). One patient had severe com-plications, which included a significant decrease in hemoglobin requiring transfusion and a perinephric hematoma with worsening renal function. This was a morbidly obese patient whose blood pressure was elevated at the time of biopsy with a platelet count of 93 × 103/mm3 and international normalized ratio of 1.21. Conclusions: A computed tomography-guided percu-taneous kidney transplant biopsy is a safe and effective alternative to obtain kidney tissue in the obese population and is associated with low rates of complications. In this study, we highlighted the need to achieve adequate blood pressure control and assess bleeding risk factors, such as platelet count and international normalized ratio, prior to biopsy.

Original languageEnglish (US)
Pages (from-to)676-681
Number of pages6
JournalExperimental and Clinical Transplantation
Volume18
Issue number6
DOIs
StatePublished - 2020

Keywords

  • Biopsy outcomes
  • Blood pressure
  • Complications
  • Renal transplant
  • Risk factors

ASJC Scopus subject areas

  • Transplantation

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