PERCUTANEOUS RENAL-ALLOGRAFT BIOPSY - A COMPARISON OF 2 NEEDLE TYPES ANALYSIS OF RISK-FACTORS

We retrospectively reviewed all (n=369) percutaneous renal allograft b iopsies performed at our institution between 1987 and 1992, comparing 14-gauge Franklin-Silverman (internal diameter=2.0 mm, n=169) and 18-g auge automated (internal diameter=1.2 mm, n=200) core biopsy needles. Visualization method, specimen adequacy, and complications were groupe d by needle type. Five or more glomeruli were present in 88.9% of spec imens obtained with Franklin Silverman needles and in 82.7% with autom ated needles. A histologic diagnosis was obtained in 94.1% and 95.5% o f Franklin-Silverman and automated biopsies, respectively. A complicat ion was detected in 27 Franklin Silverman biopsies (16.0%) and in 21 a utomated biopsies (10.5%) (not significant [NS], P>0.05). Some procedu res had more than one complication. Excluding asymptomatic gross hemat uria, incidental hematomas, and incidental arteriovenous fistulas dete cted by routine ultrasonography, clinically significant complication r ates were 6.5% for Franklin-Silverman biopsies and 2.5% for automated biopsies (NS). No allograft losses or patient deaths occurred as a res ult of allograft biopsy. Subgroup analysis of all biopsies performed w ith ultrasound marking alone (Franklin-Silverman, n=119; automated, n= 148) revealed no significant (NS) difference in complication rates (15 .1% vs. 10.8%). Additional subgroup analyses of palpation, ultrasound marking, and real-time ultrasonographic visualization techniques withi n each needle type also revealed no significant difference in the comp lication rate. Biopsy within 30 days of transplantation and no antihyp ertensive therapy were the only factors univariately associated (P<0.0 5) with an increased complication rate. Multivariate analysis found bi opsy within 30 days of transplantation (P=0.007) was associated with t he overall presence of one or more complications of any type. Type of needle (Franklin-Silverman vs. automated) achieved borderline signific ance (P=0.047) when time to biopsy was statistically adjusted for; the Franklin-Silverman needle had a higher complication rate.