Benefits and risks of protocol biopsies in pediatric renal transplantation.

Protocol biopsies are defined as sampling of allograft tissue at predetermined times regardless of function. This procedure can be justified due to the lack of non-invasive methods to reliably diagnose rejection (acute or subclinical). Changes in creatinine are not seen with subclinical rejection or...

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Publicado en:Pediatric Nephrology Vol. 34; no. 4; pp. 593 - 599
Autores principales: Gordillo, Roberto, Munshi, Raj, Monroe, Eric J., Shivaram, Giridhar M., Smith, Jodi M.
Formato: diagnostic images exam questions review Journal Article
Publicado: Springer Nature Apr2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2019
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      pub: Springer Nature
      place: New York, New York
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        atl: Benefits and risks of protocol biopsies in pediatric renal transplantation.
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        au:
          Gordillo, Roberto
          Munshi, Raj
          Monroe, Eric J.
          Shivaram, Giridhar M.
          Smith, Jodi M.
        affil: Division of Nephrology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
      sug:
        subj:
          Biopsy
          Kidney Transplantation
          Allografts
          Pediatric Care
          Risk Assessment
          Protocols
          Graft Rejection
          Creatinine Blood
          Graft Survival
      ab: Protocol biopsies are defined as sampling of allograft tissue at predetermined times regardless of function. This procedure can be justified due to the lack of non-invasive methods to reliably diagnose rejection (acute or subclinical). Changes in creatinine are not seen with subclinical rejection or early acute rejection and do not always correlate with efficacy of treatment. Parents and providers are still hesitant to pursue protocol biopsy due to the potential complications and lack of definitive evidence of a benefit from doing this procedure. Importantly, the rate of transplant renal biopsy complications requiring additional intervention is low. It is unclear if detection and treatment of subclinical rejection detected on protocol biopsy will lead to improved graft survival. Our goal is to review the literature on this topic and share some of the experience in our center. Definition, indications, and complications of diagnostic transplant renal biopsies are not included in this review.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        exam questions
        review
        Journal Article
      ougenre: Article
    language: English
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