Percutaneous Ultrasound-Guided Kidney Transplant Biopsy Outcomes: From the Nephrologist to the Radiologist Standpoint

• Published in: Kidney360 2022-10, Vol.3 (10), p.1746-1753
• Main Authors: Mattiazzi, Adela D, Cortesi, Camilo A, Patil, Rhea J, Carias Martinez, Karla G, Sedki, Mai, Cabeza Rivera, Franco H, Ruiz, Phillip, Salsamendi, Jason T, Guerra, Giselle
• Format: Article
• Language: English
• Subjects: Anticoagulants; Female; Hematoma - etiology; Humans; Image-Guided Biopsy - adverse effects; Kidney - diagnostic imaging; Kidney Diseases - complications; Kidney Transplantation - adverse effects; Nephrologists; Original Investigation; Radiologists; Retrospective Studies; Ultrasonography, Interventional - adverse effects
• ISSN: 2641-7650; 2641-7650
• DOI: 10.34067/KID.0000332022

Kidney transplant biopsies are the gold standard for evaluating allograft dysfunction. These biopsies are performed by nephrologists and radiologists under real-time ultrasound guidance. A few studies have examined the outcomes of ultrasound-guided kidney transplant biopsy in transplant recipients; however, none have compared these outcomes between both specialties. We retrospectively analyzed a cohort of 678 biopsies performed in a single center during a 44-month study period. Biopsies were stratified into two groups based upon the specialist performing the procedure: interventional radiology (IR; =447) and transplant nephrology (TN; =231). There were 55 (8%) complications related to biopsies in the entire cohort: 37 (8.2%) in the IR group and 18 (7.7%) in the TN group, without statistical difference between the groups ( =0.94). Blood pressure control and prior use of anticoagulation were significant predictors of complicated biopsies ( =0.004 and 0.02, respectively). Being a woman and prior use of anticoagulation were significant predictors of transfusion of blood products ( =0.01 and 0.01, respectively). Being a woman and blood pressure control were significant predictors of overall perinephric hematoma ( =0.01 and 0.01, respectively), and Black race was a significant predictor of perinephric hematoma without worsening of renal function ( =0.005). The specialist team performing the procedure was not a statistically significant predictor of biopsy complications, transfusion of blood products, or perinephric hematoma with comparable sample yield. Percutaneous ultrasound-guided kidney transplant biopsy performed by transplant nephrologists have similar complication rates when compared with interventional radiologists in an academic center.