Renal allograft biopsies are usually performed under USS guidance in x-ray department by the radiologist. If it is a non urgent biopsy the request should be made on TRAK. Urgent biopsy requests should be discussed with a Consultant Radiologist.
All patients must have:
1. Consent
- must be obtained by the doctor performing the biopsy.
- patients 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
2. Clotting screen
- For biopsy to proceed results required:
- blood pressure
- platelets > or = to 60 x 109L.
- PT - prolongation of < 3 seconds.
- if patient on Warfarin an INR of < or = 1.5. APTT normal.
- Group and save.
3. FBC
4. Heparin discontinued
5. Aspirin / Warfarin discontinued.
6. Oral Fluids only
7. 10mls clotted blood sample for HLA antibodies should be sent to the BTS lab.
Results 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 (bleep 5044 or tel. 27150) and Professor David Harrison (contact through switchboard) are the contacts for pathology.
- 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.
- Biopsy results must be documented in the patient’s case notes and on Proton problem list/ transplant screen (when available).
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