Comparison of palpation-guided and ultrasound-guided biopsies in transplanted kidneys

Biopsy is the gold standard for the diagnosis of conditions affecting the f unction of renal allografts. Obtaining representative tissue in biopsies is critical but these procedures are associated with up to 9% of complication s and 20% of inadequate material. Although ultrasound guidance allows perfe ct control of depth and location of the graft, there is controversy regardi ng the cost-benefit of its use and reports of unsuitable material in ultras ound-guided biopsies are still high. Purpose: To compare ultrasound with the palpation method to guide biopsies in order to see if there is any difference between both methods and which o ne is better. Patients and methods: The casuistic consisted of 82 renal transplant patien ts (32 female and 50 male patients, age ranging between 5 and 64 yr; m = 31 .2 yr) randomized into two groups: GI, palpation-guided: GII, ultrasound-gu ided. Fifty-six biopsies were performed in GI and 66 in GII. Results: Number of glomeruli, arcuate, and interlobar arteries and arteriol es were compared in the two groups and were 503 (m = 10) vs. 801 (m = 12.9) , 24 (m = 0.5) vs. 38 (m = 0.6), 104 (m = 2.1) vs. 154 (m = 2.5), and 174 ( m = 3.5) vs. 264 (4.3). respectively (p < 0.05). Inadequate material for an alysis in GI and GII was 7.1 and 7.6%, respectively (p = 0.72). Conclusions: Although ultrasound guidance improves the number of glomeruli, arcuate, and interlobar arteries, as well as arterioles, compared with pal pation-guided biopsies, there is no difference in the rate of adequate mate rial between the two methods.