Yıl 2023,
Cilt: 4 Sayı: 1, 477 - 486, 20.07.2023
Zuhal Atan Uçar
,
Ayşe Sinangil
,
Ala Elcircevi
,
Mustafa Emre Özçilsal
,
İbrahim Halil Sever
,
Sadık Server
,
Alaattin Yıldız
,
Tevfik Ecder
,
Emin Barış Akin
Kaynakça
- 1. Hariharan S, Johnson CP, Bresnahan BA, et al. Improved graft survival after renal transplantation in United States; 1988-1996. N Eng J Med. 2000; 342: 605-612.
- 2. Colvin RB. The renal allograft biopsy. Kidney Int. 1996; 50: 1069-1082.
- 3. Al-Awwa I, Hariharan S, First MR. The importance of allograft biopsy in renal transplant recipients: correlation between clinical and histological diagnosis. Am J Kidney Dis. 1998; 31: S15-S18.
- 4. Gaber L. Role of renal allograft biopsy in multicentre clinical trials in transplantation. Am J Kidney Dis. 1998; 31: S19–S25.
- 5. Parfrey P, Kuo Y, Hanley J, et al. The diagnostic and prognostic value of renal allograft biopsy. Transplantation. 1984; 38: 586-590.
- 6. Matas AJ, Sibley R, Mauer M, et al. The value of needle renal allograft biopsy. I. A retrospective study of biopsies performed during putative rejection episodes. Ann Surg. 1983; 197: 226-237.
- 7. Matas AJ, Tellis VA, Sablay L, et al. The value of needle renal allograft biopsy. III. A prospective study. Surgery. 1985; 98: 922-926.
- 8. Akhtar F, Rana TA, Kazi J, et al. Correlation between biopsies and noninvasive assessment of acute graft dysfunction. Transplant Proc. 1998; 30: 3069.
- 9. Wilckzek HE. Percutaneous needle biopsy of the renal allograft. A safety evaluation of 1129 biopsies. Transplantation. 1990; 50: 790-797.
- 10. Nyman R, Cappelen-Smith J, Al Suhaibani H, et al. Yield and complications in percutaneous renal biopsy. A comparison between ultrasound-guided gun-biopsy and manual techniques in native and transplant kidneys. Acta Radiol. 1997; 38:431–436.
- 11. Diaz-Buxo J, Donadio JV Jr. Complication of percutaneous renal biopsy: an analysis of 1000 consecutive biopsies. Clin Nephrol. 1975; 4:223–227.
- 12. Stiles K, Yuan C, Chung E, et al. Renal biopsy in high-risk patients with medical disease of the kidney. Am J Kidney Dis. 2000; 36:419–433.
- 13. Kersnik LT, Kenig A, Buturovic PJ, et al. Real-time ultrasound-guided renal biopsy with a biopsy gun in children: safety and efficacy. Acta Paediatr. 2001; 90:1394–1397.
- 14. Chesney D, Brouhard B, Cunningham R. Safety and cost effectiveness of pediatric percutaneous renal biopsy. Pediatr Nephrol. 1996; 10:493–495
- 15. Mahoney M, Racadio J, Merhar G, et al. Safety and efficacy of kidney transplant biopsy: Tru-Cut needle vs sonographically guided biopsy gun. AJR Am J Roentgenol. 1993; 160:325–326.
- 16. Seyahi N, Koçyiğit İ, Ateş K, et al. Current status of renal replacement therapy in Turkey: A summary of 2020 turkish society of nephrology registry report. Turk J Nephrol. 2022;31(2):103-109.
- 17. Cameron JS. Glomerulonephritis in renal transplant. Transplantation. 1982;34:237-45.
- 18. Cheigh JS, Stenzel KH, Susin M, et al. Kidney transplant nephrotic syndrome. Am J Med. 1974;57:730-40.
- 19. Cheigh JS, Mouradian J, Susin M et al. Kidney transplant nephrotic syndrome: relationship between allograft histopathology and natural course. Kidney Int. 1990;18:358
- 20. Shapiro RS, Deshmukl A, Kropp K. Massive post-transplant proteinuria. Transplantation. 1976;22:489-92.
- 21. Colvin RB, Cohen AH, Saiontz C, et al. Evaluation of pathologic criteria for acute renal allograft rejection: reproducibility, sensitivity, and clinical correlation. J Am Soc Nephrol. 1997;8(12):1930–1941.
- 22. Sorof JM, Vartanian RK, Olson JL, et al. Histopathological concordance of paired renal allograft biopsy cores. effect on the diagnosis and management of acute rejection. Transplantation. 1995;60(11):1215–1219.
- 23. Van LE, Lerut E, Naesens M, et al. The time-dependency of renal allograft histology. Transpl Int. 2017. 29:1-22.
- 24. Sellarés J. et al, de Freitas DG, Mengel M, et al. Understanding the causes of kidney transplant failure: The dominant role of antibody-mediated rejection and nonadherence. Am. J. Transplant. 2012;12(2):388–399.
- 25. Ramos E, Drachenberg CB, Papadimitriou JC, et al. Clinical Course of Polyoma Virus Nephropathy in 67 Renal Transplant Patients. J. Am. Soc. Nephrol. 2002;13(8):2145–2151.
- 26. Leeaphorn N, Thongprayoon C, Chon WJ, et al. Outcomes of kidney retransplantation after graft loss as a result of BK virus nephropathy in the era of newer immunosuppressant agents. Am. J. Transplant. 2020;20(5):1334–1340.
- 27. Vasudev B, Hariharan S, Hussain SA, et al. BK virus nephritis: Risk factors, timing, and outcome in renal transplant recipients. Kidney Int. 2005;68(4):1834–1839.
- 28. Favi E, Puliatti C, Sivaprakasam R et al. Incidence, risk factors, and outcome of BK polyomavirus infection after kidney transplantation. World J. Clin. Cases. 2019;7(3):270–290.
- 29. Myint TM, Chong CHY, Wyld M, et al. Polyoma BK Virus in Kidney Transplant Recipients: Screening, Monitoring, and Management. Transplantation. 2022;106(1):E76–E89.
Clinicopathological Results of Percutaneous Transplant Kidney Biopsies: Single Center Nine Years' Experience
Yıl 2023,
Cilt: 4 Sayı: 1, 477 - 486, 20.07.2023
Zuhal Atan Uçar
,
Ayşe Sinangil
,
Ala Elcircevi
,
Mustafa Emre Özçilsal
,
İbrahim Halil Sever
,
Sadık Server
,
Alaattin Yıldız
,
Tevfik Ecder
,
Emin Barış Akin
Öz
Background: Based on clinical criteria alone, the cause of graft dysfunction cannot be accurately predicted in 40-70% of cases. Therefore, renal allograft biopsy is still the gold standard for accurate diagnosis. We performed this study to evaluate the causes of renal graft dysfunction detected in renal allograft biopsies in our center.
Methods: The results of 90 patients who underwent renal allograft biopsy between May 2013 and June 2022 from kidney transplant patients were evaluated retrospectively.
Results: It was determined that 92 biopsies were performed from 90 patients and all were ‘cause’’ biopsies. The mean age was 40.03±14.29 years. 82 of the kidney transplants were from living donors. 21 patients had preemptive transplantation. The type of renal replacement therapy before transplantation was hemodialysis in 52 patients, PD in 3 patients, PD and HD in 3 patients. The reason for biopsy was high creatinine in 67 patients, proteinuria in 23 patients, and BKV viremia in 2 patients. The mean discharge creatinine value was 1.64±1.11mg/dl, and the mean creatinine before biopsy was 3.06±2.07mg/dl. Although there was kidney tissue in one of the allograft biopsies, there was no glomeruli. The mean number of cores taken was 2.94±0.61, and the number of glomeruli was 21.33±11.64. In one of the 92 biopsies performed, bleeding requiring transfusion developed. No other biopsy-related complications were observed. Graft loss was observed in 46 of 90 patients during the follow-up period.
Conclusions: Evaluation of serum creatinine and urinalysis may be useful in predicting histological graft diagnosis, but an allograft biopsy is necessary for definitive diagnosis.
Kaynakça
- 1. Hariharan S, Johnson CP, Bresnahan BA, et al. Improved graft survival after renal transplantation in United States; 1988-1996. N Eng J Med. 2000; 342: 605-612.
- 2. Colvin RB. The renal allograft biopsy. Kidney Int. 1996; 50: 1069-1082.
- 3. Al-Awwa I, Hariharan S, First MR. The importance of allograft biopsy in renal transplant recipients: correlation between clinical and histological diagnosis. Am J Kidney Dis. 1998; 31: S15-S18.
- 4. Gaber L. Role of renal allograft biopsy in multicentre clinical trials in transplantation. Am J Kidney Dis. 1998; 31: S19–S25.
- 5. Parfrey P, Kuo Y, Hanley J, et al. The diagnostic and prognostic value of renal allograft biopsy. Transplantation. 1984; 38: 586-590.
- 6. Matas AJ, Sibley R, Mauer M, et al. The value of needle renal allograft biopsy. I. A retrospective study of biopsies performed during putative rejection episodes. Ann Surg. 1983; 197: 226-237.
- 7. Matas AJ, Tellis VA, Sablay L, et al. The value of needle renal allograft biopsy. III. A prospective study. Surgery. 1985; 98: 922-926.
- 8. Akhtar F, Rana TA, Kazi J, et al. Correlation between biopsies and noninvasive assessment of acute graft dysfunction. Transplant Proc. 1998; 30: 3069.
- 9. Wilckzek HE. Percutaneous needle biopsy of the renal allograft. A safety evaluation of 1129 biopsies. Transplantation. 1990; 50: 790-797.
- 10. Nyman R, Cappelen-Smith J, Al Suhaibani H, et al. Yield and complications in percutaneous renal biopsy. A comparison between ultrasound-guided gun-biopsy and manual techniques in native and transplant kidneys. Acta Radiol. 1997; 38:431–436.
- 11. Diaz-Buxo J, Donadio JV Jr. Complication of percutaneous renal biopsy: an analysis of 1000 consecutive biopsies. Clin Nephrol. 1975; 4:223–227.
- 12. Stiles K, Yuan C, Chung E, et al. Renal biopsy in high-risk patients with medical disease of the kidney. Am J Kidney Dis. 2000; 36:419–433.
- 13. Kersnik LT, Kenig A, Buturovic PJ, et al. Real-time ultrasound-guided renal biopsy with a biopsy gun in children: safety and efficacy. Acta Paediatr. 2001; 90:1394–1397.
- 14. Chesney D, Brouhard B, Cunningham R. Safety and cost effectiveness of pediatric percutaneous renal biopsy. Pediatr Nephrol. 1996; 10:493–495
- 15. Mahoney M, Racadio J, Merhar G, et al. Safety and efficacy of kidney transplant biopsy: Tru-Cut needle vs sonographically guided biopsy gun. AJR Am J Roentgenol. 1993; 160:325–326.
- 16. Seyahi N, Koçyiğit İ, Ateş K, et al. Current status of renal replacement therapy in Turkey: A summary of 2020 turkish society of nephrology registry report. Turk J Nephrol. 2022;31(2):103-109.
- 17. Cameron JS. Glomerulonephritis in renal transplant. Transplantation. 1982;34:237-45.
- 18. Cheigh JS, Stenzel KH, Susin M, et al. Kidney transplant nephrotic syndrome. Am J Med. 1974;57:730-40.
- 19. Cheigh JS, Mouradian J, Susin M et al. Kidney transplant nephrotic syndrome: relationship between allograft histopathology and natural course. Kidney Int. 1990;18:358
- 20. Shapiro RS, Deshmukl A, Kropp K. Massive post-transplant proteinuria. Transplantation. 1976;22:489-92.
- 21. Colvin RB, Cohen AH, Saiontz C, et al. Evaluation of pathologic criteria for acute renal allograft rejection: reproducibility, sensitivity, and clinical correlation. J Am Soc Nephrol. 1997;8(12):1930–1941.
- 22. Sorof JM, Vartanian RK, Olson JL, et al. Histopathological concordance of paired renal allograft biopsy cores. effect on the diagnosis and management of acute rejection. Transplantation. 1995;60(11):1215–1219.
- 23. Van LE, Lerut E, Naesens M, et al. The time-dependency of renal allograft histology. Transpl Int. 2017. 29:1-22.
- 24. Sellarés J. et al, de Freitas DG, Mengel M, et al. Understanding the causes of kidney transplant failure: The dominant role of antibody-mediated rejection and nonadherence. Am. J. Transplant. 2012;12(2):388–399.
- 25. Ramos E, Drachenberg CB, Papadimitriou JC, et al. Clinical Course of Polyoma Virus Nephropathy in 67 Renal Transplant Patients. J. Am. Soc. Nephrol. 2002;13(8):2145–2151.
- 26. Leeaphorn N, Thongprayoon C, Chon WJ, et al. Outcomes of kidney retransplantation after graft loss as a result of BK virus nephropathy in the era of newer immunosuppressant agents. Am. J. Transplant. 2020;20(5):1334–1340.
- 27. Vasudev B, Hariharan S, Hussain SA, et al. BK virus nephritis: Risk factors, timing, and outcome in renal transplant recipients. Kidney Int. 2005;68(4):1834–1839.
- 28. Favi E, Puliatti C, Sivaprakasam R et al. Incidence, risk factors, and outcome of BK polyomavirus infection after kidney transplantation. World J. Clin. Cases. 2019;7(3):270–290.
- 29. Myint TM, Chong CHY, Wyld M, et al. Polyoma BK Virus in Kidney Transplant Recipients: Screening, Monitoring, and Management. Transplantation. 2022;106(1):E76–E89.