SAT-173 Trans-jugular Renal Biopsy, single centre experience

Abstract

Historically percutaneous renal biopsy was the initial and favored method to obtain renal tissue, in 1989 the first accidental trans jugular kidney biopsy (TJKB) was described while targeting liver biopsy, there is a lot of situation where trans-jugular approach is more suitable including morbid obesity, bleeding tendency, conditions prevent the prone position, solitary kidney or essentially single functioning kidney, failed percutaneous renal biopsy and ICU patients. We will describe our technique of trans-jugular renal biopsy (TJRB) and present its efficacy and safety. We retrospectively collected patients who had their trans-jugular renal biopsy in the period between (December 2018 till April 2019), and reviewed their clinical & laboratory data, complications and adequacy of samples from patients' records. A histopathology technician had examined the tissue samples for adequacy. 4 patients, Age between 18-35 years, had 4 TJKB procedures. The procedure was technically successful in all patients with Three to Five passes (mean 3.2) were made per biopsy, with an overall yield of 14-38 glomeruli, providing a definite diagnosis in all the patients, Though capsular perforation developed in 1 patients, with HB drop from 81à70 without major complication.Tabled 1CasesAgeIndication for TJRBUPCR +/- hematuriaBMIDrop in Hb 1 day post procedureNumber of PassComplication & Need for US post BxNo. of glomeruli in renal biopsyBlood transfusionDiagnosisCase129YSuspected Renal vein thromboses & was on therapeutic enoxaparin10g/g272.0 g3Non2 Core 28 Glom.NonMCD + IgA nephropathyCase235YSLE with inflamed Kidney6g/g290.3 g3Non3 Core 38 Glom.NonLupus IIIc +VCase334YSLE with right renal infarct9g/g241.0 g5Sub-capsular hematoma. US KUB: thin Rim of free fluid around the kidney around (6cc)3Core 14 Glom.1Unit of PRBcs 3 days post BxLupus III+VCase418YObesity0.4g/g hematuria370.0 g3Non3CoreNonThin membrane disease Open table in a new tab So in conclusion TJKB Shows to be safe & effective in obtaining adequate tissue diagnosis in patients who appear to be at high risk for complications or contraindications to percutaneous renal biopsy.