Incidence and Predictors of Post-Kidney Biopsy (KBx) Bleeding in Liver Transplant (LT) Candidates with Renal Dysfunction
1Department of Transplant, Mayo Clinic, Jacksonville, FL, 2Department of Medicine, Division of Nephrology, Mayo Clinic, Jacksonville, FL
Meeting: 2019 American Transplant Congress
Abstract number: A293
Keywords: Biopsy, Kidney/liver transplantation, Renal dysfunction
Session Information
Session Name: Poster Session A: Liver - Kidney Issues in Liver Transplantation
Session Type: Poster Session
Date: Saturday, June 1, 2019
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall C & D
*Purpose: Pre-LT kidney biopsy is seldom performed in LT candidates with renal dysfunction and/or proteinuria partially due to the limited information regarding KBx bleeding. We aimed at identifying the incidence and predictors of bleeding after KBx in LT candidates.
*Methods: We retrospectively examined variables associated with post-KBx bleeding in 128 LT candidates who underwent pre-LT KBx for kidney dysfunction, proteinuria and/or hematuria. Post-KBx bleeding was defined as the need for ≥2 units of packed red blood cells transfusion (PRBCs) or the need for selective embolization. Patients had an initial INR and platelet count checked the morning of the biopsy. Fresh frozen plasma (FFP) and/or platelet transfusion were administered as needed to lower INR to <1.5 and raise platelet count to >50,000.
*Results: Post-KBx bleeding developed in 16 (12%) patients, 5 of whom underwent selective embolization while bleeding spontaneously stopped in 11 patients. Predictors of post-KBx bleeding are presented in Table 1.
*Conclusions: 1) Post-KBx bleeding in LT candidates with renal dysfunction occurred in 12% of patients but only 5 (4%) required selective embolization. 2) Candidates who experienced post-KBx bleeding had higher initial INR and lower initial platelet count and their final INR and platelet count did not significantly change despite requiring higher number of FFP and platelet transfusion prior to the biopsy. 3) Kidney function, duration of dialysis, kidney size, biopsy approach and number of kidney biopsy passes did not impact post-KBx bleeding risk.
To cite this abstract in AMA style:
Wadei HM, Abader P, Aslam N, Jarmi T, Keaveny AP, Croome K, Lee DD, Taner C. Incidence and Predictors of Post-Kidney Biopsy (KBx) Bleeding in Liver Transplant (LT) Candidates with Renal Dysfunction [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/incidence-and-predictors-of-post-kidney-biopsy-kbx-bleeding-in-liver-transplant-lt-candidates-with-renal-dysfunction/. Accessed December 11, 2024.« Back to 2019 American Transplant Congress