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Is renal biopsy of intra-peritoneally placed kidney transplants associated with excessive risk? [Abstract]

Ilham, Mohamed Adel, Haque, Ali, Pritchard, Michael, Griffiths, David A. and Asderakis, Argirios 2009. Is renal biopsy of intra-peritoneally placed kidney transplants associated with excessive risk? [Abstract]. Transplant International 22 (S2) , p. 294. 10.1111/j.1432-2277.2009.00963.x

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Abstract

Introduction: Renal transplant biopsy allows adequate diagnosis of graft dysfunction.However it has its complications. Renal transplants are occasionally placed intra-peritoneally particularly in simultaneous kidney pancreas transplantation(SPK). Biopsy from such kidneys is expected to be more challenging and fraught with complications compared to extra-peritoneally placed organs due to the absence of external tamponade. Aim: Examine the safety and utility of kidney biopsies of intra-peritoneally placed renal (IPK) transplant in the setting of SPK. Patients and results: All renal transplant biopsies of IPK were performed under ultrasound guidance using an 18 gauge automated biopsy needle. Biopsies were evaluated by light microscopy and further cores were taken if required for adequate pathological evaluation. Patients had bed rest six hours post biopsy with regular observation. If a patient was on warfarin or heparin it was stopped beforehand. However, aspirin was not stopped. All patients had their coagulation profile evaluated before biopsy. From 1/2005 to 10/2008, 43 biopsies of IPK were performed in 20 patients out of 41 with SPK. All biopsies had adequate material for pathological diagnosis.24 biopsies revealed rejection, while 19 biopsies revealed other pathological diagnoses (ATN, CNI toxicity). One patient suffered from bleeding that required exploration and 4 patients received blood transfusion (2 of them though because they had a low Hb prior to the IPK biopsy). There were minor episodes of post biopsy haematuria early following the procedure but none was associated with clots in the urine or required catheterisation for retention. Conclusion: Renal transplant biopsy of intra-peritoneally placed adult kidneys in the context of SPK provides valuable information to aid diagnosis and management of patients, and it is safe, therefore it should not be avoided. However it should be dealt with more cautiously than biopsies from extra-peritoneally placed kidneys

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Postgraduate Medical and Dental Education
Subjects: R Medicine > RD Surgery
Publisher: European Society for Organ Transplantation
ISSN: 1432-2277
Last Modified: 10 Oct 2017 13:40
URI: http://orca-mwe.cf.ac.uk/id/eprint/17990

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