title: Complications of Ultrasound-Guided Renal Transplant Biopsies.
abstract: Renal transplant biopsies to diagnose transplant pathology are routinely performed using ultrasound guidance. Few large studies have assessed the rate and risk factors of major biopsy complications. This study is a single-center 5-year retrospective cohort analysis of 2514 biopsies. Major complications occurred in 47 of 2514 patients (1.9%) and included hospitalization, transfusion of blood products, operative exploration and interventional radiology procedures. The complication rate among "cause" biopsies was significantly higher than in "protocol" biopsies (2.7% vs. 0.33%, p < 0.001). Complications presented on postbiopsy days 0-14, with the majority diagnosed on the same day as the biopsy and manifested by hematocrit drop, although the presence of such delayed presentation of complications occurring >24 h after the biopsy on days 2-14 is previously unreported. Specific patient characteristics associated with increased risk of a complication were increased age and blood urea nitrogen, decreased platelet count, history of prior renal transplant, deceased donor transplant type and use of anticoagulant medications but not aspirin.
authors.affiliation: Department of Radiology and Biomedical Imaging, Univeristy of California San Francisco, San Francisco, CA.
authors.forename: T A
authors.initials: TA
authors.lastname: Morgan
authors.affiliation: Kidney Transplant Service, Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: S
authors.initials: S
authors.lastname: Chandran
authors.affiliation: Department of Radiology, Kaiser Permanente Los Angeles/VA Greater Los Angeles Healthcare System, Los Angeles, CA.
authors.forename: I M
authors.initials: IM
authors.lastname: Burger
authors.affiliation: Department of Radiology and Biomedical Imaging, Univeristy of California San Francisco, San Francisco, CA.
authors.forename: C A
authors.initials: CA
authors.lastname: Zhang
authors.affiliation: Department of Radiology and Biomedical Imaging, Univeristy of California San Francisco, San Francisco, CA.
authors.forename: R B
authors.initials: RB
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects*; D007223:Infant; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000009:adverse effects*; D055815:Young Adult