Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes
Background: Protocol biopsy in renal allograft helps to early detect subclinical rejection (SCR) in patients who have no abnormal clinical and laboratory findings. Still, there are rare reports about the techniques and outcomes of two-week protocol biopsy. The aim of this study was to assess two-wee...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/785 |
| _version_ | 1797486880346865664 |
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| author | Manuel Lim Byung Kwan Park Kyo Won Lee Jae Berm Park Kyeong Deok Kim Jaehun Yang Jieun Kwon Eun Sung Jeong Seunghwan Lee |
| author_facet | Manuel Lim Byung Kwan Park Kyo Won Lee Jae Berm Park Kyeong Deok Kim Jaehun Yang Jieun Kwon Eun Sung Jeong Seunghwan Lee |
| author_sort | Manuel Lim |
| collection | DOAJ |
| description | Background: Protocol biopsy in renal allograft helps to early detect subclinical rejection (SCR) in patients who have no abnormal clinical and laboratory findings. Still, there are rare reports about the techniques and outcomes of two-week protocol biopsy. The aim of this study was to assess two-week protocol biopsy regarding the technical feasibility, procedure safety, and clinical outcomes. Methods: A total of 894 protocol biopsies were performed in adult recipients between 2012 and 2019. Two-week and one-year protocol biopsies were guided with ultrasound in 842 and 399 patients by one of four radiologists with wide range of biopsy experience, respectively. These protocol biopsies were compared in terms of feasibility and safety. Standard references were clinico-laboratory findings and biopsy examinations. Results: The median period of two-week and one-year protocol biopsies were 12 days (10–20 days) and 383 days (302–420 days), respectively. All protocol biopsies were technically successful and there was no difference between radiologists regarding technical success and complications (<i>p =</i> 0.453). Major complication (Clavien–Dindo grading II–IV) rates of two-week and one-year protocol biopsies were 0.3% (3/842) and 0.2% (1/399), respectively (<i>p =</i> 1.000). However, univariate analysis demonstrated that platelet count < 100 K/mL and blood urea nitrogen ≥ 40 mg/dL were associated with major complications in two-week protocol biopsy. The SCRs of these protocol biopsies were 15.4% (130/842) and 33.6% (134/399), respectively (<i>p <</i> 0.001). Conclusion: Two-week protocol biopsy is technically feasible and safe. It contributes to early detecting a substantial number of SCRs. Prior to the biopsy, platelet count and blood urea nitrogen should be carefully checked to predict major complications. |
| first_indexed | 2024-03-09T23:39:39Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:39:39Z |
| publishDate | 2022-01-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-200e4fd76b71421b9e3cbb4c6039d6e42023-11-23T16:53:57ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111378510.3390/jcm11030785Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and OutcomesManuel Lim0Byung Kwan Park1Kyo Won Lee2Jae Berm Park3Kyeong Deok Kim4Jaehun Yang5Jieun Kwon6Eun Sung Jeong7Seunghwan Lee8Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Kyung Hee University Hospital at Gangdong, Seoul 05278, KoreaBackground: Protocol biopsy in renal allograft helps to early detect subclinical rejection (SCR) in patients who have no abnormal clinical and laboratory findings. Still, there are rare reports about the techniques and outcomes of two-week protocol biopsy. The aim of this study was to assess two-week protocol biopsy regarding the technical feasibility, procedure safety, and clinical outcomes. Methods: A total of 894 protocol biopsies were performed in adult recipients between 2012 and 2019. Two-week and one-year protocol biopsies were guided with ultrasound in 842 and 399 patients by one of four radiologists with wide range of biopsy experience, respectively. These protocol biopsies were compared in terms of feasibility and safety. Standard references were clinico-laboratory findings and biopsy examinations. Results: The median period of two-week and one-year protocol biopsies were 12 days (10–20 days) and 383 days (302–420 days), respectively. All protocol biopsies were technically successful and there was no difference between radiologists regarding technical success and complications (<i>p =</i> 0.453). Major complication (Clavien–Dindo grading II–IV) rates of two-week and one-year protocol biopsies were 0.3% (3/842) and 0.2% (1/399), respectively (<i>p =</i> 1.000). However, univariate analysis demonstrated that platelet count < 100 K/mL and blood urea nitrogen ≥ 40 mg/dL were associated with major complications in two-week protocol biopsy. The SCRs of these protocol biopsies were 15.4% (130/842) and 33.6% (134/399), respectively (<i>p <</i> 0.001). Conclusion: Two-week protocol biopsy is technically feasible and safe. It contributes to early detecting a substantial number of SCRs. Prior to the biopsy, platelet count and blood urea nitrogen should be carefully checked to predict major complications.https://www.mdpi.com/2077-0383/11/3/785kidney transplantationprotocol biopsycomplication |
| spellingShingle | Manuel Lim Byung Kwan Park Kyo Won Lee Jae Berm Park Kyeong Deok Kim Jaehun Yang Jieun Kwon Eun Sung Jeong Seunghwan Lee Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes Journal of Clinical Medicine kidney transplantation protocol biopsy complication |
| title | Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes |
| title_full | Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes |
| title_fullStr | Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes |
| title_full_unstemmed | Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes |
| title_short | Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes |
| title_sort | two week protocol biopsy in renal allograft feasibility safety and outcomes |
| topic | kidney transplantation protocol biopsy complication |
| url | https://www.mdpi.com/2077-0383/11/3/785 |
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