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Core needle biopsy in renal transplantation
I E Geçim1, P Rowlands, I McDicken
1Department of Transplantation, Royal Liverpool University Hospital, UK.
International Urology and Nephrology
|January 1, 1995
Summary
Ultrasound-assisted core biopsies using the Biopty system are effective for diagnosing renal transplant complications. This method provides sufficient tissue for accurate pathological diagnoses, proving superior to fine needle aspiration biopsy.
Area of Science:
- Nephrology
- Transplant Surgery
- Pathology
Background:
- Renal transplant graft dysfunction requires accurate diagnosis.
- Distinguishing between various causes of graft dysfunction is critical for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of ultrasound-assisted core biopsies using the Biopty system in renal transplant recipients.
- To assess the diagnostic accuracy of this method for various transplant complications.
Main Methods:
- 140 renal transplant cases underwent ultrasound-assisted core biopsies with an 18-G Biopty system.
- Biopsies were performed for non-functioning or deteriorating grafts.
- Pathological and clinical parameters were correlated for diagnostic confirmation.
Main Results:
- The biopsy procedure was successful in 99.5% of cases, yielding sufficient tissue in 88%.
- High diagnostic accuracy was achieved for acute cellular rejection, pyelonephritis, acute tubular necrosis, and disease recurrence.
- Clinical diagnoses of chronic vascular rejection (93.7%) and Cyclosporin A toxicity (91.7%) were confirmed.
- Complications occurred in 3 patients (bowel perforation, intra-abdominal bleeding, arteriovenous fistula), all managed successfully.
Conclusions:
- Ultrasound-assisted core biopsy with the Biopty system is an efficient and safe diagnostic tool for renal transplant complications.
- This method offers superior diagnostic capability compared to fine needle aspiration, particularly for diagnoses requiring tissue analysis.