Renal allograft biopsies are performed under USS guidance in x-ray department by the radiologist.
Urgent biopsy requests should be discussed with a Consultant Radiologist. If it is a non-urgent biopsy the Trak request needs to be completed and does not require further discussion.
All patients must have:
- Must be obtained by the doctor requesting the biopsy
- Patient informed of risks
- Significant bleeding (requiring blood transfusion / further surgical intervention) is approximately 1-2%
- The risk of graft loss is <1 in 250 biopsies, and probably less in current era
- For biopsy to proceed results required:
- platelets > or = to 80 x 109L
- PT – prolongation of < 3 seconds
- if patient on Warfarin an INR of < or = 1.5. APTT normal
- Group and save
Heparin should be stopped the evening prior to the planned biopsy
Aspirin / Warfarin discontinued
Oral Fluids only
Antibody samples should be sent to Tissue Typing on all patients receiving a biopsy
Results, Consent Form and Pathology Form must be attached to front of case notes for the attention of radiologist (if samples are required for EM and immunofluorescence then this must be clearly indicated on the request card. These are required if de novo / recurrence of a primary glomerulonephritis is suspected).
Pathology Department contacted and told of the biopsy and arrangements made to collect the specimens.
Pathology request forms:
- Must be filled in by the doctor requesting the biopsy
- Clinical problem stated on the form
- Unless otherwise stated it will be assumed that samples for light microscopy and frozen section are required
- If sample for immunofluorescense or electron microscopy is required this must be stated on the form
- Request form must be attached to the front of the case notes
- Dr. Chris Bellamy is the contact person for pathology bleep 5044 or tel. 27150
- Weekend on call Pathologist can be contacted via RIE switchboard
Post biopsy observations should be recorded:
- every 15 mins for first 30 mins
- every 30 mins for 2 hours
- 4 hourly