Blood pressure and hemorrhagic complication risk after renal transplant biopsy

Leesburg, VA, April 20, 2021–An award-winning Scientific Electronic Exhibit to be presented at the ARRS 2021 Virtual Annual Meeting found no statistically significant threshold for increased renal transplant biopsy risk based on systolic (SBP), diastolic (DBP), or mean arterial (MAP) blood pressure alone.

“When these metrics are combined,” first author Winston Wang of the Mayo Clinic Arizona cautioned, “the risk of complication is significantly higher when the SBP is >= 180 mm Hg, DBP is >= 95 mm Hg, and MAP is >= 116 mm Hg.”

Wang and team’s review of consecutive ultrasound-guided renal transplant biopsies from August 1, 2015 to July 31, 2017 noted recordings of SBP, DBP, and MAP for each patient prior to entering the procedure room. Although no blood pressure threshold to cancel the biopsy was indicated, the development of a major bleeding complication (Common Terminology Classification for Adverse Events grade 3 and above) had been recorded in the electronic medical record.

Of the 1,689 biopsies on 958 patients (547 men, 411 women) meeting the inclusion criteria, only 10 (0.59%) had bleeding complications, and Wang et al. observed no statistically significant difference between biopsies with complication compared to those without complication for SBP (p = 0.351), DBP (p = 0.088), or MAP (p = 0.132).

Acknowledging that previous studies also showed scant correlation between major hemorrhagic complication of renal transplant biopsy and elevated SBP and DBP, compared to normotensive patients, “the data is limited, based on only 4 complications,” the authors of this Cum Laude ARRS Annual Meeting Scientific Electronic Exhibit added.

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