Korean J Transplant.  2023 Nov;37(Suppl 1):S154. 10.4285/ATW2023.F-0000.

Current safety and outcomes of kidney allograft biopsy

• Paek JH
• Yang J
• Kwon JK
• Lee HJ
• Kim Y
• Park WY
• Jin K
• Han S

• KMID: 2551774
• DOI: http://doi.org/10.4285/ATW2023.F-0000

Abstract

Background
Kidney allograft dysfunction has various causes and presentations. Although many studies on biomarkers for detection of kidney allograft dysfunction were performed, kidney biopsy remains the gold standard for the diagnosis of kidney allograft dysfunction. However, there are concerns about the risks and complications. This study aimed to clarify the safety and clinical significance of kidney allograft biopsy.
Methods
We retrospectively reviewed histopathological findings of 485 patients who received kidney allograft biopsy between 2005 and 2021. All kidney allograft biopsies were performed by nephrologist using ultrasound guidance.
Results
The mean period from kidney transplantation to allograft biopsy was 56.3±67.6 months. Of the 485 allograft biopsies, there were 61 (12.6%) protocol biopsies. Eighty-six patients (17.7%) suffered complications and the complication rate between indication biopsy and protocol biopsy was comparable (18.2% vs. 14.8%, P=0.515). The rate of major complications including blood transfusion and radiologic intervention was 1.9% and there was no graft loss. Patients who received blood transfusion had significantly lower kidney allograft chronicity scores (cg, ci, ct, and cv) and higher levels of blood urea nitrogen and creatinine than those without transfusion. Multivariable Cox proportional hazard models revealed that rejections (hazard ratio [HR], 3.714; 95% confidence interval [CI], 1.166–11.831; P=0.026) and glomerular disease (HR, 8.580; 95% CI, 2.627–28.029; P<0.001) were associated with increased risk of death censored graft failure compared to minor glomerular change.
Conclusions
Kidney allograft biopsy is considered to be safe with acceptable complications. Also, it is essential for the correct diagnosis and future therapeutic plan.