Renal Transplant Biopsy Risk Threshold Greater When Based on Combined BP Values

April 19, 2021
Whitney J. Palmer

Using systolic, diastolic, and mean arterial blood pressure values together results is a greater threshold for risk.

The threshold for risk associated with renal transplant biopsy is much greater when systolic (SBP), diastolic (DBP), or mean arterial (MAP) blood pressure are evaluated together.

In an award-winning poster presented during the ARRS 2021 Virtual Annual Meeting, Winston Wang, MS, from the Mayo Clinic Arizona detailed there is no statistically significant threshold for increased risk based on each of these values alone.

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“When these metrics are combined,” he said, ”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.”

For their study, Wang’s team reviewed consecutive ultrasound-guided renal transplant biopsies conducted between Aug. 1, 2015, and July 31, 2017. They pulled pre-procedure data from each patient for SBP, DBP, and MAP. Developments of a major bleeding complication – denoted as Common Terminology Classification for Adverse Events grade 3 and above – were recorded in the electronic medical record, but there was no indication of a blood pressure threshold to cancel the biopsy, they said.

The team evaluated 1,689 biopsies from 958 patients – 547 men and 411 women -- and they discovered only 10 patients (0.59 percent) had bleeding complications. Their analysis showed there was no statistically significant difference between biopsies with complication and those without complication for SBP (p=0.351), DBP (p=0.088), or MAP (P=0.132).

The team did note that previous research has also indicated a slight correlation between major hemorrhagic complications of renal transplant biopsy and elevated SBP and DBP values when compared to patients who have normal-range blood pressure.

“The data is limited, based on only four complications,” they concluded.

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