Böbrek transplant alıcılarında allograft biyopsisinin histopatolojik değerlendirilmesi ve komplikasyonları: Radyolojik görüntüleme açısından

Amaç: Böbrek nakli, son dönem böbrek yetmezliği olan hastaların çoğunda tercih edilen tedavi yöntemi haline gelmiştir. Renal allogreft biyopsisi böbrek nakli disfonksiyonunun tanısında en önemli tekniktir. Bu çalışmada, radyolojik görüntüleme ışığında renal transplant hastalarında histopatolojik değerlendirme ve komplikasyon tipleri ve sıklığının araştırılması amaçlandı. Gereç ve Yöntemler: Bu retrospektif çalışmada, Ocak 2000 ve Aralık 2007 tarihleri arasında böbrek biyopsisi yapılan renal transplantasyonlu hastaların histopatolojik biyopsi sonuçları, kalsinörin inhibitörü ilaç düzeyi ile toksisite gelişimi arasındaki ilişki açısından değerlendirildi. Ayrıca biyopsi ile ilişkili komplikasyonlar araştırıldı. Bulgular: Toplam 386 hasta çalışmaya dahil edildi ve bu hastalara 843 biyopsi yapıldı. Doku miktarı 812 biyopside (% 96) yeterli, 6 biyopside (% 1) yetersiz ve 27 biyopside (% 3) sınırlı ancak histopatolojik değerlendirme için yeterli bulunmuştur. Akut ret, tübüler epitel hasarı ve kronik allogreft nefropati en sık konulan tanılardı. Biyopsilerin komplikasyonları 4 biyopside makroskopik hematüri (%0.57), 6 biyopside perirenal hematom (% 1) ve 1 biyopside arteriyovenöz fistül (% 0.15) idi. Sonuç: Böbrek allogreft disfonksiyonunu değerlendirmek için nakil yapılan hastalarda böbrek biyopsisi çok düşük komplikasyon oranına sahip güvenli bir yöntemdir.

Anahtar Kelimeler:

böbrek nakli, allogreft biyopsisi, kanama, arteryo-venöz fistül

Histopathologic evaluation and complications of allograft biopsy in renal transplant recipients: In terms of radiologic imaging

Aim: Renal transplantation has become the treatment of choice for most patients with end-stage renal disease. Renal allograft biopsy is the most important technique in diagnosis of renal transplant dysfunction. In the light of radiological imaging, we investigated histopathologic evaluation and types and incidence of complications in renal transplant patients. Material and Methods: In this retrospective study, histopathological biopsy results of patients with renal transplantation who underwent renal biopsy between January 2000 and December 2007 were evaluated in terms of the relationship between calcineurin inhibitor drug level and toxicity development. In addition, biopsy related complications were investigated. Results: In a total of 386 patients were included in the study and 843 biopsies were performed on these patients. The amount of tissue was adequate in 812 biopsies (96%), inadequate in 6 biopsies (1%) and of limited adequacy in 27 biopsies (3%) for histopathologic evaluation. Acute rejection, tubular epithelial injury and chronic allograft nephropathy were the most frequent diagnoses. Complications of the biopsies were macroscopic hematuria in 4 biopsies (0.5%), perirenal hematoma in 6 biopsies (1%), and arteriovenous fistula in 1 biopsy (0.1%). Conclusion: Renal biopsy in transplant patients to evaluate the renal allograft dysfunction is a safe method with very low incidence rate of complications.

Keywords:

renal transplantation, allograft biopsy, bleeding, arteriovenous fistula,

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