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- Title
Routine haemostasis testing before transplanted kidney biopsy: a cohort study.
- Authors
Kuiper, Gerhardus J. A. J. M.; Christiaans, Maarten H. L.; Mullens, Monique H. J. M.; ten Cate, Hugo; Hamulýak, Karly; Henskens, Yvonne M. C.
- Abstract
Summary: Kidney biopsy can result in bleeding complications. Prebiopsy testing using bleeding time (BT) is controversial. New whole blood haemostasis tests, such as platelet function analyser‐100 (PFA‐100) and multiple electrode aggregometry (MEA), might perform better. We postulated that PFA‐100 would be suitable to replace BT prebiopsy. In 154 patients, transplanted kidney biopsies were performed after measurement of bleeding time, PFA‐100, MEA and mean platelet volume (MPV). Bleeding outcome (haemoglobin (Hb) drop, haematuria (±bladder catheterization), ultrasound finding of a bleeding, need for (non)surgical intervention and/or transfusion) after the biopsy was correlated to each test. Male–female ratio was 2:1. 50% had a surveillance biopsy at either three or 12 months. Around 17% (had) used acetylsalicylic acid (ASA) prebiopsy. Of 17 bleeding events, one subject needed a transfusion. Most bleeding events were Hb reductions over 1 mmol/l and all resolved uneventful. BT, PFA‐100, MEA and MPV did not predict a bleeding outcome; prior ASA use however could (odds ratio 3.19; 95%‐CI 1.06 to 9.61). Diagnostic performance data and Bland–Altman analysis showed that BT could not be substituted by PFA‐100. ASA use was the best determinant of bleeding after kidney biopsy. Routine haemostasis testing prebiopsy has no added value.
- Subjects
HEMOSTASIS; BLOOD coagulation; HEMORRHAGE; BIOPSY; CLINICAL pathology
- Publication
Transplant International, 2018, Vol 31, Issue 3, p302
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.13090