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.
Division of Nephrology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
Clodagh
C
Sweeney
Denis F
DF
Geary
Diane
D
Hebert
Lisa
L
Robinson
Valerie
V
Langlois
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