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.
|[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 23, 2020.
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