Abstract
Background: Protocol biopsy in renal allograft helps to early detect subclinical rejection (SCR) in patients who have no abnormal clinical and laboratory findings. Still, there are rare reports about the techniques and outcomes of two-week protocol biopsy. The aim of this study was to assess two-week protocol biopsy regarding the technical feasibility, procedure safety, and clinical outcomes. Methods: A total of 894 protocol biopsies were performed in adult recipients between 2012 and 2019. Two-week and one-year protocol biopsies were guided with ultrasound in 842 and 399 patients by one of four radiologists with wide range of biopsy experience, respectively. These protocol biopsies were compared in terms of feasibility and safety. Standard references were clinico-laboratory findings and biopsy examinations. Results: The median period of two-week and one-year protocol biopsies were 12 days (10–20 days) and 383 days (302–420 days), respectively. All protocol biopsies were technically successful and there was no difference between radiologists regarding technical success and complications (p = 0.453). Major complication (Clavien–Dindo grading II–IV) rates of two-week and one-year protocol biopsies were 0.3% (3/842) and 0.2% (1/399), respectively (p = 1.000). However, univariate analysis demonstrated that platelet count < 100 K/mL and blood urea nitrogen ≥ 40 mg/dL were associated with major complications in two-week protocol biopsy. The SCRs of these protocol biopsies were 15.4% (130/842) and 33.6% (134/399), respectively (p < 0.001). Conclusion: Two-week protocol biopsy is technically feasible and safe. It contributes to early detecting a substantial number of SCRs. Prior to the biopsy, platelet count and blood urea nitrogen should be carefully checked to predict major complications.
Highlights
Percutaneous biopsy is accepted as a gold standard for identifying the cause of renal allograft dysfunction [1]
Most of our initial early protocol biopsies were performed around 2 weeks, and a substantial number of subclinical rejection (SCR) were detected in patients who do not have clinical or laboratory findings of acute rejection
There are only a few studies reporting the value of early protocol biopsy to determine if it can detect SCR when it is performed within one month [30,31]
Summary
Percutaneous biopsy is accepted as a gold standard for identifying the cause of renal allograft dysfunction [1]. Several researchers have reported that acute rejection is revealed at an early stage with protocol biopsy and that early detection and treatment of SCR improves clinical outcomes before renal dysfunction [5,6,7,8]. Protocol biopsy in renal allograft helps to early detect subclinical rejection (SCR) in patients who have no abnormal clinical and laboratory findings. Conclusion: Two-week protocol biopsy is technically feasible and safe It contributes to early detecting a substantial number of SCRs. Prior to the biopsy, platelet count and blood urea nitrogen should be carefully checked to predict major complications
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
