Investigation of Complications of Kidney Transplant Biopsy in Patients With Intraperitoneal and Extraperitoneal Kidney Transplants in Labbafinezhad Hospital.

OBJECTIVES

Although the extraperitoneal approach is standard in renal transplant, intraperitoneal placement is utilized in pediatric recipients and select adult cases. Concerns exist regarding the safety of percutaneous allograft biopsy in intraperitoneally placed kidneys due to potential visceral injury. We aimed to compare biopsy-related complication rates between intraperitoneal and extraperitoneal kidney transplant recipients.

MATERIALS AND

METHODS

This retrospective cohort study (2022-2024) compared biopsy-related complications in 100 transplant recipients (50 intraperitoneal, 50 extraperitoneal) at Labbafinezhad Hospital. Only 23 patients underwent ultrasonography-guided allograft biopsy (13 intraperitoneal, 10 extraperitoneal) for clinical indications. Demographic, clinical, and transplant-related variables and postbiopsy complications were evaluated.

RESULTS

The intraperitoneal group (mean age 39 ±12 years, 69% male) and the extraperitoneal group (mean age 37 ± 13 years, 60% male) were demographically comparable (P > .05). All transplants were from living donors. No significant differences were observed in baseline characteristics, including cause of end-stage renal disease, dialysis vintage, or number of previous transplants. Postbiopsy complications were rare and of minor severity in both cohorts. One patient (7.7% ) in the intraperitoneal group developed a small hematoma (grade 3), and 1 patient (7.7% ) had a minor perinephric collection (40 mL). No such events occurred in the extraperitoneal group, but this difference was not significant (P = .565). No instances of gross hematuria, clinically significant hemoglobin drop, transfusion requirement, hypotension, fistula, or need for angioembolization were recorded in either group.

CONCLUSIONS

Ultrasonography-guided renal allograft biopsy appears to be a safe procedure with a similarly low complication profile in both intraperitoneal and extraperitoneal transplant recipients. Despite theoretical risks associated with intraperitoneal organ placement, our study found no evidence of increased major or minor complications, supporting the safety of percutaneous biopsy in this population when performed with image guidance.