【Background】Percutaneous and ultrasound-guided renal allograft biopsy (RAB) is a gold standard procedure to evaluate renal allograft rejection. Because RAB is a relatively invasive test, we evaluated risk of its complications and prognoses of the graft thereafter.

【Method】This study was a single center retrospective cohort analysis of 325 RAB in 272 patients between 2013 and 2016. The biopsy was conducted percutaneously and ultrasound-guidedly, using 18G or 16G needle. We compared patient background between patients with and without complications of RAB.

【Results】 40 complications (12.3%) occurred in 325 RAB. They were 1 hematoma (0.3%), 7 hematuria (2.2%), 30 AVF in 30 patients (9.2%), and 2 deep vein thromboses (DVT; 0.62%). Comparison of patient background between those with complications (n=40) and the rest (n=232) revealed that there was a significant difference in graft weight (205±55g vs. 177±46g; p=0.023) and everolimus intake (p=0.047). In a hematoma case, a small mass developed around the graft which spontaneously disappeared in a few weeks. Hematuria was defined as more than 100/HPF RBC in urine sediment. Although one such a case presented macroscopic hematuria, all of them resolved spontaneously. Serum eGFR levels after biopsy were comparable between AVF group (n=30) and non-AVF group (n=242) with no graft loss by AVF. Two patients with symptomatic DVT required re-admission and had high level of BMI (>30). Although one resulted in pulmonary embolism, they were resolved with anticoagulant therapy.

【Conclusion】About one out of every 10 RAB was associated with a complication. Graft weight and everolimus intake were significant risk factors of complications with RAB. Although AVF was the most frequent one (9.2%), the graft function after developing it was comparable with that of non-AVF cases. However a life threatening complication of pulmonary embolism occurred in one case, probably due to compression around the allograft and bed rest for a few hours after the procedure. So we have to pay attention to the formation of thrombosis after RAB especially in an obese patient.

CITATION INFORMATION: Ide H, Iwadoh K, Nakajima I, Fuchinoue S. Risk and Prognosis of Developing Procedural Complications in Renal Allograft Biopsy, Including AVF and DVT. Am J Transplant. 2017;17 (suppl 3).

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