MATERIAL AND METHODS:

From Januray 2014 to August 2016, 183 US-guided renal graft biopsies were performed in our institution.

We decided to optimize our biopsy protocol, from 24 hours hospitalization and observation of patients undergoing biopsy to outpatient protocol of 6 hours observation. We evolved from initially shared technique by radiologists and nephrologist together to US guided biopsy performed by the nephrologist alone.

We also changed from 14 G biopsy needle to 16 G needle over the same period.

We retrospectively analyzed results of those changes and compared each group

RESULTS:

183 renal graft biopsies performed. 79,8% done by radiologist and nephrologist together. 20,2% by nephrologist alone. Outpatient protocol with 6 hours of observation was performed on 51,4% of patients. 48,6% underwent admission and 24 hours of observation. Automatic biopsy gun of 14 G were used in 43,2%, 16 G in 37,7%, 18 G in 6%. In 13,1% needle information was not recorded.

Mean age 54 ± 14, 66,7% male. Mean needle passes 2 ± 1, mean number of samples 1,5 ±0,5. Mean pre-biopsy hemoglobin levels 11,5 ± 1,8 gr/dl, post-biopsy 10,9 ± 1,75 gr/dl, and mean Hb change was 0,65 ± 0,62. Mean obtained glomeruli was 18 ± 11.

14 G biopsy gun mainly used for inpatient protocol ( 52%) and for nephrologist – radiologist shared technique ( 54,8%),16 G biopsy gun was mainly used in outpatient cases ( 47%) and in all nephrologist alone cases.

Overall rate of complications was 7,7%, higher in shared technique cases vs. Nephrologist alone cases ( 8,2 vs 5,4%). No differences between complications in the inpatient vs. outpatient cases ( 7,8 vs. 7,4%).

More complications in 14 G compared to 16 G needle ( 11,2 vs. 4,3%)

Only one case ( 0,3%) required intravascular segmental embolization due to severe active bleeding after biopsy. There were no nephrectomies or deaths during the study period.

CONCLUSIONS:

We observed less complications using 16 G biopsy needle compared with 14 G.

No differences in complications between inpatient vs. outpatient with 6 hours of observation protocol.

Less complications when biopsy performed by nephrologist alone compared with shared technique. When comparing only 16 G cases, complication rates were similar.

We believe US-guided renal graft biopsy using 16 G needle, with 6 hours observation after procedure and performed by nephrologist alone is safe,efficient, cost-saving and optimizes the renal graft biopsy process.

CITATION INFORMATION: Juega J, Perez M, Cañas L, Troya M, Bancu I, Bonet J, Lauzurica R. Technical Characteristics, Optimization and Outcomes of Ultrasound-Guided Biopsy Performed on Kidney Transplant Patients. Am J Transplant. 2017;17 (suppl 3).

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