Color Doppler Guided in Early Renal Allograft Biopsy: A Safer and Non-Inferior Technique
Issued Date
2023-01-01
Resource Type
ISSN
00411345
eISSN
18732623
Scopus ID
2-s2.0-85174734614
Journal Title
Transplantation Proceedings
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transplantation Proceedings (2023)
Suggested Citation
Jeerararuensak W., Taweemonkongsap T., Larpparisuth N., Tantranont N., Chotikawanich E., Jitpraphai S., Woranisarakul V., Hansomwong T. Color Doppler Guided in Early Renal Allograft Biopsy: A Safer and Non-Inferior Technique. Transplantation Proceedings (2023). doi:10.1016/j.transproceed.2023.09.016 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/90869
Title
Color Doppler Guided in Early Renal Allograft Biopsy: A Safer and Non-Inferior Technique
Author's Affiliation
Other Contributor(s)
Abstract
Background: This study compared a novel technique for renal allograft biopsy, color Doppler ultrasound-guided biopsy (CDUS-Bx), with routine ultrasound-guided biopsy (RUS-Bx). Methods: A retrospective review was conducted on 111 patients, with 42 undergoing CDUS-Bx and 69 undergoing RUS-Bx. Urologists used an 18-gauge automatic spring-loaded biopsy needle for all procedures. CDUS-Bx tissue collection was guided by identifying renal vessels with color Doppler mode. Results: Overall, the adequacy rate was 90.1%, with a higher number of glomeruli obtained in the CDUS-Bx group (25.6 ± 10.3 vs. 20.6 ± 11.3, P =.008). Acute tubular necrosis was the most frequent pathological diagnosis, with a higher prevalence in the CDUS-Bx group (69% vs 40.6%). T cell–mediated rejection had a lower incidence in the CDUS-Bx group (4.8% vs 21.7%), and antibody-mediated rejection was comparable between the 2 groups. The most common complication was microscopic hematuria, which was significantly less frequent in the CDUS-Bx group (48.7% vs 70.1%, P =.028), but there was no significant difference in the rate of gross hematuria between CDUS-Bx and RUS-Bx (11.9% vs 11.6%, P =.961). The number of cores was the only predictor of adequate biopsy, with a 93.2% adequacy rate after 3 cores of allograft biopsy. Multivariate analysis revealed that only the guiding type, CDUS-Bx, was associated with less microscopic hematuria (adjusted odds ratio 0.325, P =.018). Conclusions: Color Doppler ultrasound-guided biopsy had comparable tissue adequacy to RUS-Bx, with a lower incidence of microscopic hematuria. These findings suggest that CDUS-Bx may be a safe and effective alternative to RUS-Bx for allograft biopsy.