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01-04-2019 | Educational Review

Benefits and risks of protocol biopsies in pediatric renal transplantation

Authors: Roberto Gordillo, Raj Munshi, Eric J. Monroe, Giridhar M. Shivaram, Jodi M. Smith

Published in: Pediatric Nephrology | Issue 4/2019

Abstract

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.

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Title: Benefits and risks of protocol biopsies in pediatric renal transplantation
Authors: Roberto Gordillo
Raj Munshi
Eric J. Monroe
Giridhar M. Shivaram
Jodi M. Smith
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 4/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-3959-6

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