Detection of bleeding complications after renal transplant biopsy

Anika G. Patel, J. Scott Kriegshauser, Scott W. Young, Nirvikar Dahiya, Maitray D. Patel

Research output: Contribution to journalArticlepeer-review


OBJECTIVE. The purpose of this study was to analyze the timing of major bleeding complications after renal transplant biopsy in the context of a standardized 1-hour postprocedure observation protocol. MATERIALS AND METHODS. We retrospectively reviewed the electronic medical records for consecutive patients who underwent ultrasound-guided renal transplant biopsies between January 1, 2012, and December 31, 2017, and were observed according to a newly implemented 1-hour postprocedure observation protocol. The development of a major bleeding complication (Common Terminology Criteria for Adverse Events class 3 or higher) was recorded along with all available details regarding the time course of patient symptoms and presentation. Complications were grouped into one of four categories according to onset time after biopsy: 2 hours or less (timing category 1), more than 2 hours but 4 hours or less (timing category 2), more than 4 hours but 8 hours or less (timing category 3), and more than 8 hours (timing category 4). RESULTS. In 1824 patients (769 women, 1055 men) who underwent 4519 consecutive ultrasound-guided renal transplant biopsies during the study period, 11 class 3 complications were found (11/4519 [0.2%]). Four of the 11 patients (36.4%) had symptoms during the 1-hour observation period. Of these four patients, three (3/11 [27.3%]) had substantial symptoms related to major bleeding and were classified as timing category 1, and one (1/11 [9.1%]) had initially minor symptoms that increased in severity more than 2 hours but within 4 hours and was classified as timing category 2. Seven of the 11 patients (63.6%) did not have any symptoms at 1 hour of observation and were discharged; three (27.3%) were classified as timing category 3, and four (36.4%) were classified as category 4. CONCLUSION. Major bleeding complications following ultrasound-guided renal transplant biopsy are rare (0.2% of patients in this study). In our study, more than half were not clinically apparent within 4 hours of biopsy. A 1-hour postprocedure recovery period can be safely used after renal transplant biopsy.

Original languageEnglish (US)
Pages (from-to)428-435
Number of pages8
JournalAmerican Journal of Roentgenology
Issue number2
StatePublished - Feb 2021


  • Biopsy
  • Complication
  • Recovery
  • Renal transplant
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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