THE RISK EVALUATION OF ULTRASOUND GUIDED RENAL BIOPSY IN RENAL TRANSPLANT RECIPIENTS

Renal parenchymal biopsy and pathologic evaluation of transplanted kidney supply valuable diagnostic information. However, the invasive nature of biopsy procedure limits its widespread use in many centers. We undertook this prospective study to find out the rate and clinical importance of complications in our series of patients undergoing biopsy.

One hundred thirty-six biopsy procedures in 86 adult patients were performed under ultrasonographic guldence. In all biopsies the needle was tangentially directed from anterior to lateral aspect of the upper half of the kidney to obtain a cortical core avoiding any medullary or sinus contact. In all of the patients manual tru-cut technique was used. In 63% of biopsies, 14 G needle was used. Two biopsy passes were performed in 70% of biopsies.

An average of 34±19 (mean±SD) glomerules obtained in the biopsies. The biopsy specimens were adequate for diagnosis in 93% of the procedures. Five (4%>) biopsies were complicated. Hematoma was diagnosed in the perirenal space in 3, and in the anterior abdominal wall in 2 of the cases. An arteriovenous fistula was accompanying one of the cases with perirenal hematoma. All of the compilations regressed spontaneously. The needle size was 14G in 3, and 16G in 2 of the complicated procedures. In all of them, 2 biopsy passes had been made. No statistical relation was found between the development of complications and needle size or number of specimens.

We concluded that, although it is invasive and has potential for complications, biopsy of the transplanted kidneys under sonographic guldence is a diagnostic and safe method. The rate of complications is low. Furthermore, developing complications are mostly mild and self limiting in nature.