Kidney allograft biopsy: timing to complications.
Nephrology and Transplant, Surgery
Biopsy, Female, Hematuria, Hemorrhage, Humans, Kidney Transplantation, Male, Middle Aged, Outpatients, Prospective Studies, Risk Factors, Time Factors, Transplantation, Homologous
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; Recupero, P; McKenna, J; Vella, J; and Parker, M G, "Kidney allograft biopsy: timing to complications." (2010). Maine Medical Center. 2138.