COMPLICATIONS OF AMBULANT RENAL TRANSPLANT BIOPSIES

 

A. Schwarz 1, W. Gwinner 1, M. Hiss 1, J. Radermacher 1, U. Eisenberger 1, M. Mengel 2, H. Haller 1

Department of Nephrology 1, Department of Pathology 2 Hannover Medical School, D-30625 Hannover, Germany

 

In order to establish a protocol biopsy program after renal transplantation, we started to do renal transplant biopsies on a day-care basis in December 2000. Since then, we performed 1011 ambulant biopsies in 527 patients. Biopsies were done using an 18-gauge automated biopsy needle, thereafter 4 hours bed rest in hospital with blood pressure and urine control as well as ultrasound before and after biopsy; keeping the patient in hospital in cases of complications or rejection.

 

Results: 735 protocol biopsies after renal transplantation were performed in 288 patients (1st biopsy after 6 weeks, n=227; 2nd biopsy after 12 weeks, n= 260; 3rd biopsy after 6 months, n=227); as well as 276 biopsies in 239 renal transplant patients on indication (creatinine increase or proteinuria). The following biopsy complications in 1011 renal transplant biopsies of  527 patients were observed:

 

Gross hematuria                                  n = 39  (3.9%)

            hospitalization*                  15

            urinary catheter**                          11

            blood transfusion***                       1

Perirenal hematoma (ultrasound)          n = 22  (2.2%)

            hospitalization*                    5

            blood transfusion***                       3

Vasovagal reaction                              n =   6

            hospitalisation*                    3

Av-fistula (doppler sonography)           n = 89  (8.8%)

            persistent****                                 9

            spontaneous resolution       34

            without control                   46

 

(hospitalization* 2.3%; urinary catheter** 1.1%; blood transfusion*** 0.4%; relevant av-fistula**** 0.2%).

 

There was no statistically significant difference between complications in protocol biopsies and biopsies on indication: hematuria, 3.8 vs 4 %, ns; perirenal hematoma, 2.2 vs 2.2 %, ns; vasovagal reaction, 0.8 vs 0%, ns; av-fistula, 8.7 vs 9.1%, ns.       

 

We conclude that outpatient renal transplant biopsies can be performed safely and allow to establish a protocol biopsy program. Relevant biopsy complications like gross hematuria or perirenal hematoma usually are noticed during the 4 hours bed rest following the biopsy. Biopsy-induced av-fistula are frequent and usually either resolve spontaneously or remain without clinical importance.

 

 

 

 

COMPLICATIONS OF AMBULANT RENAL TRANSPLANT BIOPSIES

 

A. Schwarz 1, W. Gwinner 1, M. Hiss 1, J. Radermacher 1, U. Eisenberger 1, M. Mengel 2, H. Haller 1

Department of Nephrology 1, Department of Pathology 2                    Hannover Medical School, D-30625 Hannover, Germany

 

 

 

 

Mailing Address:

 

Dr. Anke Schwarz

Department of Nephrology

Hannover Medical School

Carl-Neuberg Strasse 1

D-30625 Hannover

 

Phone : +49 511 5326319

FAX:   +49 511 552366

E-Mail: schwarz.anke@mh-hannover.de