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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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Autores principales: Lim, Manuel, Park, Byung Kwan, Lee, Kyo Won, Park, Jae Berm, Kim, Kyeong Deok, Yang, Jaehun, Kwon, Jieun, Jeong, Eun Sung, Lee, Seunghwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836907/
https://www.ncbi.nlm.nih.gov/pubmed/35160237
http://dx.doi.org/10.3390/jcm11030785
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author Lim, Manuel
Park, Byung Kwan
Lee, Kyo Won
Park, Jae Berm
Kim, Kyeong Deok
Yang, Jaehun
Kwon, Jieun
Jeong, Eun Sung
Lee, Seunghwan
author_facet Lim, Manuel
Park, Byung Kwan
Lee, Kyo Won
Park, Jae Berm
Kim, Kyeong Deok
Yang, Jaehun
Kwon, Jieun
Jeong, Eun Sung
Lee, Seunghwan
author_sort Lim, Manuel
collection PubMed
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 (p = 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 (p = 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 (p < 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.
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spelling pubmed-88369072022-02-12 Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes Lim, Manuel Park, Byung Kwan Lee, Kyo Won Park, Jae Berm Kim, Kyeong Deok Yang, Jaehun Kwon, Jieun Jeong, Eun Sung Lee, Seunghwan J Clin Med Article 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 (p = 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 (p = 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 (p < 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. MDPI 2022-01-31 /pmc/articles/PMC8836907/ /pubmed/35160237 http://dx.doi.org/10.3390/jcm11030785 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lim, Manuel
Park, Byung Kwan
Lee, Kyo Won
Park, Jae Berm
Kim, Kyeong Deok
Yang, Jaehun
Kwon, Jieun
Jeong, Eun Sung
Lee, Seunghwan
Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836907/
https://www.ncbi.nlm.nih.gov/pubmed/35160237
http://dx.doi.org/10.3390/jcm11030785
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