title: Pancreas allograft biopsy: safety of percutaneous biopsy-results of a large experience.
abstract: BACKGROUND
  Percutaneous pancreas allograft biopsy is the technique of choice for evaluation of pancreatic allograft rejection or dysfunction. The safety and success rate of the procedure with current surgical techniques is unclear. We report the complications and success rate in 426 consecutive percutaneous pancreas allograft biopsies performed at a single center.
  
  
  METHODS
  One hundred eighty-three patients (50% simultaneous pancreas-kidney transplant, 42% pancreas after kidney transplant, 8% pancreas transplant alone) were biopsied. Biopsies were performed using an 18-gauge automated needle with ultrasound guidance.
  
  
  RESULTS
  Thirty-seven patients had four or more biopsies (maximum, 11). Two hundred fifteen (50%) biopsies were in patients with bladder exocrine drainage, 211 (50%) in patients with enteric exocrine drainage. Of the latter, 33 (16%) were in patients with portal venous drainage. Eighty-eight percent of biopsy specimens were adequate for histologic diagnosis. There were 12 biopsy-related complications (2.8%), including eight episodes of bleeding (1.9%), five of which (1.2%) required surgical intervention and one possible extra-graft exocrine leak. Other complications included inadvertent liver (1), kidney (1), and small bowel (1) biopsy.
  
  
  CONCLUSIONS
  Percutaneous pancreas allograft biopsy has a low rate of complication and a high success rate.
authors.affiliation: Department of Medicine, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD 21201, USA. Dklassen@medicine.umaryland.edu
authors.forename: David K
authors.initials: DK
authors.lastname: Klassen
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Weir
authors.forename: Charles B
authors.initials: CB
authors.lastname: Cangro
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Bartlett
authors.forename: John C
authors.initials: JC
authors.lastname: Papadimitriou
authors.forename: Cinthia B
authors.initials: CB
authors.lastname: Drachenberg
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation; D016035:Pancreas Transplantation / Q000473:pathology*; D012189:Retrospective Studies; D012449:Safety; D014184:Transplantation, Homologous / Q000473:pathology; D018615:Ultrasonography, Doppler, Color; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000601:surgery