Are Pretransplant Kidney Biopsies Safe?

Area of Science:

• Nephrology
• Transplantation Surgery
• Pathology

Background:

• Kidney transplantation is a vital procedure with approximately 500 transplants annually in Portugal.
• Procurement biopsies are studied for their predictive potential, but their risks, especially peri-transplant, are less understood.
• The period between organ harvest and transplantation presents unique risks for kidney grafts.

Purpose of the Study:

• To evaluate the risks associated with kidney procurement biopsies.
• To assess the impact of procurement biopsies on patient outcomes and resource utilization.
• To determine if procurement biopsies affect immediate post-transplant renal function.

Main Methods:

• A cross-sectional study was conducted at the University Hospital of Coimbra involving 203 kidney graft recipients between 2019 and 2020.
• Kidney biopsies were performed using a polar double core puncture technique with 18-gauge needles.
• Patient data, including hemoglobin levels, transfusion requirements, length of stay, and renal function, were analyzed.

Main Results:

• Twenty-seven percent of recipients (56 patients) received a biopsied kidney graft.
• The biopsied group experienced a more pronounced median postoperative hemoglobin fall (3.2 g/dL vs. 2.6 g/dL) and required more transfusions (2.2 U vs. 1.3 U).
• Patients receiving biopsied kidneys had longer hospital stays (13.2 days vs. 10.6 days) and longer cold ischemia times (19 hours vs. 15.2 hours).

Conclusions:

• Kidney procurement biopsies are linked to a higher risk of hemorrhage, independent of patient age.
• While procurement biopsies appear safe for recipients, they necessitate increased patient surveillance and resource consumption.
• No statistically significant difference in renal function at discharge was observed between recipients of biopsied and non-biopsied kidneys.