OPTIMAL NEEDLE SIZE FOR RENAL TRANSPLANT BIOPSY: A RETROSPECTIVE SINGLE CENTRE STUDY
Dr Jocelyn Shan1, Dr Mark Tiong1, A/Prof Paul Champion de Crespigny1,2
1Royal Melbourne Hospital, Australia, 2University of Melbourne, Australia
Aim: Renal transplant biopsies are a valuable diagnostic tool in allograft dysfunction. This study aimed to investigate the optimal biopsy needle size for efficacy and safety.
Background: Standard renal biopsy needle size differs worldwide, largely between 16G and 18G needles. Previous studies demonstrated lower complication rates with 18G needle, however, there is ongoing concern that this provides inadequate samples. To our knowledge, this is the largest study to date investigating the optimal needle size for renal transplant biopsies.
Methods: We performed a retrospective analysis of transplant kidney biopsies at our centre between 2015 and 2024. 14G, 16G or 18G automated biopsy needles were used under real time ultrasound guidance. Adequate biopsy sample was defined as 10 or more glomeruli.
Results: 2860 biopsies were performed between 2015 and 2024. 1558 with sufficient data were included in our study. More passes were performed with 18G needles (2.34 ± 0.62) than 16G (1.42 ± 0.75) and 14G needles (1.75 ± 0.97). 14G biopsies yielded the most glomeruli (17.92 ± 6.92), followed by the 18G (16.51 ± 7.14), then 16G group (14.69 ± 13.87). Biopsy samples were adequate in 82.9% of 18G biopsies, compared with 77.1% of the 16G group.
No major complications occurred in either the 14G or 18G group, however 6% of 16G biopsies had a major complication. Less total complications occurred in the 18G group (2.4%) compared with 8.3% and 9.3% in the 14G and 16G groups respectively.
Conclusion: The 18G needle when used to obtain two passes, may be superior to the 16G needle in both efficacy and safety in transplant kidney biopsies. These findings are within the limitations of a small 18G group size.
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Biography:
Jocelyn Shan is a dual Nephrology and General Medicine Advanced Trainee currently working at Royal Melbourne Hospital. She has a specific interest in interventional nephrology and chronic kidney disease associated metabolic bone disease.