Diagnostic efficacy and safety of ultrasound-guided kidney transplant biopsy using cortex-only view: a retrospective single-center study

Abstract

Purpose

Cortical biopsy is the cornerstone to reveal a cause of unexplained dysfunction of the kidney transplant. Nevertheless, only a few studies have reported the biopsy technique with its performance. We described a novel technique of ultrasound (US)-guided kidney transplant biopsy using cortex-only view and analyzed its diagnostic efficacy and safety.

Materials and methods

Between January 2014 and December 2016, a consecutive series of 188 patients who underwent US-guided kidney transplant biopsy using cortex-only view by an experienced radiologist were evaluated (mean age, 46.1 ± 12.5 years; range, 21–79 years). Biopsy time, biopsy distance, biopsy core number, and glomerular number per patient were recorded. Successful biopsy (e.g., adequate, 10 or more glomeruli; marginal, 7–9 glomeruli) and complication rates were investigated, using Banff criteria and Clavien-Dindo classification, respectively.

Results

Mean biopsy time, distance, and core number were 20.6 ± 6.7 min (range, 10–44 min), 3.2 ± 0.7 cm (range, 2.1–5.4 cm), and 1.9 ± 0.3 (range, 1.0–3.0), respectively. Mean glomerular number per patient was 20.4 ± 10.0 (range, 0–54). Adequate and marginal biopsy rates were 87.2% (164/188) and 95.2% (179/188), respectively. There was no major complication requiring treatment (no patient with Clavien-Dindo grade 2 or greater complication), while there were self-limiting minor complications in 5 patients (overall complication rate, 2.7%).

Conclusion

US-guided biopsy using cortex-only view is feasible and safe in sampling cortical tissues of kidney transplant.

Key Points

• Ultrasound (US)-guided kidney transplant biopsy using cortex-only view is feasible and safe.

• Adequate and marginal biopsy rates were 87.2% and 95.2%, respectively.

• No major complication requiring treatment occurred after biopsy.

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Change history

  • 04 February 2019

    The original version of this article, published on 17 December 2018, unfortunately contained a mistake. The following correction has therefore been made in the original: The name of Jaeseung Shin was presented incorrectly. The corrected author list is given above.

Abbreviations

BMI:

Body mass index

US:

Ultrasound

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Acknowledgements

The authors would like to thank Dong-Su Jang, MFA, (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Korea) for his help with the illustrations.

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The authors state that this work has not received any funding.

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Correspondence to Sung Yoon Park.

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The scientific guarantor of this publication is Sung Yoon Park, M.D.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Cross sectional study

• Performed at one institution

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The original version of this article was revised: The name of Jaeseung Shin was presented incorrectly.

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Cite this article

Shin, J., Park, S.Y. Diagnostic efficacy and safety of ultrasound-guided kidney transplant biopsy using cortex-only view: a retrospective single-center study. Eur Radiol 29, 5272–5279 (2019). https://doi.org/10.1007/s00330-018-5910-4

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Keywords

  • Kidney
  • Biopsy
  • Transplant
  • Allograft
  • Ultrasonography