Renal Transplant Biopsy using Real Time Ultrasound Guidance

Nicholson, M. L.; Attard, Alex R.; Bell, A.; Donnelly, P. K.; Veitch, P. S.; Bell, P. R. F.

doi:10.1111/j.1464-410x.1990.tb14820.x

Cited by 18 publications

(10 citation statements)

References 6 publications

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“…These requirements were met in 62% of our samples, and this figure approached 80% when more than one core was taken, as recommended in the Banff 97 guidelines. These results are comparable with the biopsy adequacy rates reported in the adult literature [8,9,10,11], but we are not aware of any paediatric transplant data addressing this issue, as paediatric studies have combined allograft with native kidney biopsies when looking at adequacy for histological diagnosis [12]. Many of the older studies allowed lower minimal requirements for the number of glomeruli and did not require the presence of arteries to establish a histological diagnosis in biopsy samples, potentially overestimating the achieved adequacy rates.…”

Section: Discussionsupporting

confidence: 88%

Renal transplant biopsy specimen adequacy in a paediatric population

et al. 2005

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Updated guidelines on the diagnosis of acute allograft rejection including criteria for biopsy specimen adequacy were published in 1999. We sought to determine the adequacy of specimens in paediatric transplant patients and identify factors influencing adequacy. All renal transplant biopsies performed between 1998 and 2003 were classified as adequate (n =25), minimal (n =19) or inadequate (n =27) in accordance with the Banff 97 criteria, and the histological diagnoses were documented. The effect on specimen adequacy of grade of operator, method of sedation, age of child, needle gauge, number of cores and total core length was then investigated. Overall, a minimal or adequate specimen was obtained in 62% of cases. No histological diagnosis could be made in 30% of all specimens, just over half of which were inadequate. Higher rates of rejection were found in adequate (52%) than inadequate (33%) samples. The grade of operator (p =0.498), the age of the child at the time of biopsy (p =0.815) and type of sedation (p =0.188) did not affect adequacy. More than one core was obtained in 38 (54%) cases, and this was significantly associated with specimen adequacy (p <0.0005) as was longer total core length (p =0.002). Clinical features in isolation are not sufficient for the diagnosis of acute allograft rejection. Renal biopsy remains the gold standard and relies on adequate specimen collection. Our data shows that specimen adequacy according to the Banff 97 guidelines is achievable in children and that more than one core at the time of sampling significantly improves this achievement. Adequate sampling reduces the risk of an inconclusive histological diagnosis.

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Section: Discussionsupporting

confidence: 88%

Renal transplant biopsy specimen adequacy in a paediatric population

et al. 2005

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“…The introduction of automatic biopsy needles and real‐time ultrasound‐guidance has improved the safety and success of PRB . However, the optimal needle size for native kidney PRB has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of automatic biopsy needles and real-time ultrasound-guidance has improved the safety and success of PRB. [2][3][4][5][6] However, the optimal needle size for native kidney PRB has not been established. Our retrospective study compared 16G and 18G automatic biopsy needles in nativekidney PRB.…”

Section: Discussionmentioning

confidence: 99%

“…Since its introduction, two major advances in biopsy technique have greatly improved the efficacy and safety of this procedure: the use of real time ultrasound for needle guidance and introduction of automatic biopsy needles . With these advances, traditional large bore manual needles have been replaced by smaller bore automatic needles to provide comparable adequacy with improved safety profiles …”

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confidence: 99%

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Is bigger better? A retrospective analysis of native renal biopsies with 16 Gauge versus 18 Gauge automatic needles

et al. 2013

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“…Needle-core transplant biopsies were performed under ultrasonographic guidance using a spring-loaded biopsy device 14 . All the biopsy material used in this study was taken between 3 and 24 months after transplantation at times of stable renal function.…”

Section: Patientsmentioning

confidence: 99%