Outpatient pediatric renal transplant biopsy--is it safe?
The safe observation time following pediatric renal transplant biopsy is unknown. To predict the safety of day-care pediatric renal transplant biopsy, we retrospectively evaluated the timing, incidence and severity of post-biopsy complications in children observed overnight. Biopsies were performed under real time ultrasound guidance using an 18-gauge Bard Biopty needle. Coagulation screen and platelet counts were measured preprocedure. Hemoglobin (Hb) was measured preprocedure, at 6 h and at 1-day post-procedure. Twenty-eight of 45 children transplanted between January 2002 and May 2004 underwent 65 biopsies. There was gross hematuria following 8 (12%) biopsies; 2/8 occurred after 6 h. Hb fell by >15 g/L in six cases (9%) - three had Hb drop within 6 h post-procedure and three had a steady decline over 24 h. No patient required blood transfusion. Oral analgesia post-procedure was required in seven cases (11%). One of these had gross hematuria. No patient required surgical intervention or transfusion. Three complications were recorded >6 h post-biopsy but none required intervention. Daycare renal transplant biopsy appears to be safe in selected patients.
Sweeney
Clodagh
C
Division of Nephrology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
Geary
Denis F
DF
Hebert
Diane
D
Robinson
Lisa
L
Langlois
Valerie
V
D000293:Adolescent; D000553:Ambulatory Care; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation; D015641:Radiography, Interventional; D012189:Retrospective Studies