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- W2168045691 abstract "Protocol biopsies have long been a controversial issue in kidney transplantation. Relative risk of complications of the procedure must be weighed against the possible benefit, and the patient must be fully informed before protocol biopsies can be obtained. Risk of performing kidney allograft biopsies has diminished over recent years, with the routine use of smaller gauge biopsy needles, bioptic devices to obtain tissue cores, and ultrasound guidance for the biopsy procedure. The allograft kidney is located closer to the body surface than the native kidney, making localization of the organ for biopsy more straightforward than for native kidney. As reviewed by Wilkinson, safety of protocol biopsies has been established. In cited series totalling >3500 protocol biopsies, the rate of serious complications varied from 0.4 to 1% and very rarely led to graft loss. The authors of one large multicenter study concluded that “it is ethically justifiable to ask renal transplant recipients to undergo protocol biopsies in clinical trials and routine care” (1).It is important to sample adequate renal cortex in graft biopsies to make pathologic observations on the tissue reliable and the procedure worthwhile for patient treatment. This is especially true in the setting of protocol biopsies, where the potential for benefit to the patient should outweigh any risk. Banff criteria define adequate cortical sampling as a specimen that contains at least 10 glomeruli and two arteries. Sampling of the medulla may also be desirable to optimize detection of early polyoma virus infection. It is recommended that at least two tissue cores be obtained, preferably at some distance from each other, to optimize sampling of pathologic processes such as rejection and infection, which may be focal in the allograft (2). Sampling with a 16-gauge needle provides a better tissue sample, with safety comparable to use of an 18-gauge …" @default.
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- W2168045691 date "2006-01-01" @default.
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- W2168045691 title "Protocol Transplant Biopsies in Kidney Allografts" @default.
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- W2168045691 doi "https://doi.org/10.2215/cjn.01010905" @default.
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