Safety and efficacy of kidney transplant biopsy: Tru-Cut needle vs sonographically guided Biopty gun.

Objective: We evaluated the safety and efficacy of using a 14-gauge Tru-Cut needle without imaging guidance vs using an 18-gauge Biopty gun with sonographic guidance for percutaneous biopsy of kidney transplants.

Materials And Methods: We retrospectively analyzed data from 105 biopsies (in 68 patients) in which the Biopty gun with an 18-gauge needle was used and data from 100 biopsies (in 64 patients) in which a 14-gauge Tru-Cut needle was used.

Results: Significantly fewer major complications (p = .03) occurred when the Biopty gun was used (2%) vs when the Tru-Cut needle was used (10%). Two major complications (2%), both hematuria requiring transfusion, occurred in the 105 biopsies performed with the Biopty gun. Major complications occurred in 10 (10%) of the 100 biopsies done with the Tru-Cut needle: three obstructed allografts caused by blood clots, two episodes of hypovolemic shock, one case of shock and obstruction, and four intraperitoneal hemorrhages (one of which required nephrectomy). Biopsy specimens were adequate for histopathologic diagnosis in more than 98% of cases for both the Biopty gun and the Tru-Cut needle.

Conclusion: We conclude that imaging-guided percutaneous biopsy of renal allografts with a Biopty gun is as accurate as and safer than biopsy with the Tru-Cut needle.