Kidney allograft biopsy: timing to complications.
BACKGROUND
Clinical Practice guidelines recommend that patients be observed overnight after kidney biopsy based upon data that 1/3 of bleeding complications occur 12 hours post-procedure. Retrospective studies of same day discharge after kidney allograft biopsy suggest this practice may be safe, but no prospective studies to date have examined time to bleeding complications.


METHODS
We conducted a single center, prospective, observational study of adult outpatient kidney allograft recipients undergoing elective percutaneous allograft biopsy who were observed for 8 hours post-procedure before discharge home. Bleeding complications were characterized as minor or major and tracked by time post-biopsy. Baseline demographics were assessed for correlation with complications.


RESULTS
8/124 (6.4%) of patients had a bleeding complication and 7/8 (87.5%) of complications occurred within the observation window. 3.2 % were minor and 3.2% were major complications with one major complication occurring after the 8-hour period. Neither the baseline demographics nor drop in serum hemoglobin of > 1 g/dl 6 hours after biopsy predicted a bleeding complication. However, a drop of > 1.5 g/dl correlated with a significant bleeding event (p = 0.006).


CONCLUSIONS
An 8-hour observation window captures the majority of bleeding complications after adult kidney transplant biopsy.
Yablon
Z
Z
Division of Nephrology and Transplantation, Maine Medical Center, Portland, ME, USA.
Recupero
P
P
McKenna
J
J
Vella
J
J
Parker
M G
MG
D001706:Biopsy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014184:Transplantation, Homologous