Impact of Six-Month Surveillance Biopsies and Monitoring in Pediatric Renal Transplant Recipients.
1University Health System, San Antonio, TX
2University of Texas Health Science Center San Antonio, San Antonio, TX
3University of Texas College of Pharmacy, Austin, TX
Meeting: 2017 American Transplant Congress
Abstract number: D156
Keywords: Biopsy, Kidney transplantation, Pediatric, Rejection
Session Information
Session Name: Poster Session D: Kidney: Pediatric
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Purpose: Evaluate the utility of surveillance biopsies and monitoring 6 months post-transplant.
Methods: A retrospective single center chart review of pediatric renal transplant recipients from 01/2011–10/2015 was conducted. Patients ≤18 years of age who received a renal transplant between the study dates were included and divided into two groups: patients who underwent surveillance biopsies [(SB) arm] and patients who did not (control arm). Mean peak estimated glomerular filtration rate (eGFR) was determined at 3 months post-transplant. Peak eGFR, mean percent change in eGFR, incidence of rejection, and infection-related hospitalizations were compared between the two groups 12 months post-transplant.
Results: The SB arm (n=16) and the control arm (n=18) had comparable baseline characteristics. There was no significant difference between arms for the outcomes of interest.
| Outcome | SB(n=15)* | Control(n=18) | P |
| [Delta] eGFR from peak to 12 months, %(mean±SD) | -22.9±15.7 | -13.2±16.6 | 0.094 |
| Decrease in eGFR ≥ 10 mL/min/1.73 m2, n(%) | 12(75.0) | 8(47.1) | 0.157 |
| Acute rejection, n(%) | 3(18.8) | 1(5.6) | 0.323 |
| Infection requiring hospitalization, n(%) | 2(12.5) | 2(11.1) | 1.00 |
| *One patient without 12 month follow-up at transplanting center | |||
Of the 16 surveillance biopsies performed, 6 patients had borderline rejection (3 received treatment), 9 had tacrolimus-associated toxicity, and 1 had normal histology. No patients experienced any biopsy-related complications, but a majority of patients (87.5%) required a hospital stay ≥ 24 hours for the biopsy.
Conclusions: The use of surveillance biopsies in pediatric renal transplant recipients was not associated with superior renal function at 12 months post-transplant compared to controls. Despite the low-risk of biopsy complications and infections, a majority of patients who received surveillance biopsies had a hospital length of stay ≥ 24 hours, which has significant cost implications. This analysis questions the short-term benefit of surveillance biopsies in pediatric kidney transplant recipients, but warrants long-term follow-up to determine the impact of actionable findings on surveillance biopsy.
CITATION INFORMATION: Lyons J, Ranch D, Hall R, Maxwell P, Hitchman K, Hirase Y, Crowther B. Impact of Six-Month Surveillance Biopsies and Monitoring in Pediatric Renal Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lyons J, Ranch D, Hall R, Maxwell P, Hitchman K, Hirase Y, Crowther B. Impact of Six-Month Surveillance Biopsies and Monitoring in Pediatric Renal Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-six-month-surveillance-biopsies-and-monitoring-in-pediatric-renal-transplant-recipients/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress