Pancreas transplants: experience with 232 percutaneous US-guided biopsy procedures in 88 patients

PURPOSE: To retrospectively assess the authors' experience with percutaneous ultrasonographic (US)-guided biopsy of pancreas transplants. MATERIALS AND METHODS: Data from 232 percutaneous US-guided pancreas transplant biopsies performed in 88 patients were retrospectively reviewed. Biopsies were typically performed on an outpatient basis by using local anesthesia. Considerations included the indication for the biopsy, the type of pancreas transplant, the number of needle passes, the size of the biopsy needle, the use of aspirin, and the success of the biopsy. Important complications were detailed. RESULTS: Of the 232 biopsies performed, 78 were for clinically indicated reasons and 154 were for surveillance purposes. The number of biopsy procedures per patient ranged from one to nine (mean, 2.6). Two needle passes were performed in 196 (84.5%) of the biopsy procedures. Almost all biopsies (ie, 228 [98.3%]) were performed by using an 18-gauge biopsy device. Adequate pancreatic tissue was obtained in 223 (96.1%) of the procedures. One hundred sixty-seven biopsies (72.0%) were performed while patients were receiving therapeutic aspirin. Six biopsies (2.6%) resulted in clinically important complications: three cases of intraabdominal hemorrhage and one case each of gross hematuria, allograft pancreatitis, and severe pain requiring overnight hospitalization. Two of the four bleeding complications occurred while patients were receiving therapeutic aspirin. CONCLUSION: US-guided biopsy of pancreas transplants yielded tissue that was adequate more than 96% of the time. Important complications in this study were few (2.6%) and did not appear to be related to aspirin use.