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J Vasc Interv Radiol. 2017 Feb;28(2):188-194. doi: 10.1016/j.jvir.2016.10.021. Epub 2016 Dec 16.

Effects of Aspirin Therapy on Ultrasound-Guided Renal Allograft Biopsy Bleeding Complications.

Author information

1
Department of Radiology, 200 First Street SW, Rochester, MN 55905. Electronic address: baffour.francis@mayo.edu.
2
Division of Nephrology and Hypertension, 200 First Street SW, Rochester, MN 55905.
3
Department of Medicine, Division of Transplant Surgery, 200 First Street SW, Rochester, MN 55905.
4
Department of Surgery, Division of Biomedical Statistics and Informatics, 200 First Street SW, Rochester, MN 55905.
5
Division of Ultrasound, 200 First Street SW, Rochester, MN 55905.
6
Division of Abdominal Imaging, 200 First Street SW, Rochester, MN 55905.
7
Division of Surgery Research Services, 200 First Street SW, Rochester, MN 55905; Department of Health Sciences Research, and William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Abstract

PURPOSE:

To determine if patient aspirin exposure and timing affect bleeding risk after renal allograft biopsy.

MATERIALS AND METHODS:

Review of 6,700 renal allograft biopsies (in 2,362 unique patients) was performed. Median patient age was 53.0 years [interquartile range 43.0, 62.0]; 56.2% of patients were male. Of biopsies, 4,706 (70.2%) were performed in patients with no aspirin exposure within 10 days of biopsy; 664 (9.9%), were performed within 8-10 days of aspirin exposure; 855 (12.8%), within 4-7 days; and 475 (7.1%), within 0-3 days. Follow-up to 3 months after the procedure was completed in all patients. Biopsies were categorized as protocol or indication; 19.7% were indication biopsies. Bleeding complications were graded based on SIR criteria. Logistic regression models examined the association between aspirin use and bleeding events.

RESULTS:

Rate [95% confidence interval] of major bleeding complications was 0.24% [0.14, 0.39], and rate of any bleeding complication was 0.66% [0.46, 0.90]. Bleeding events were significantly associated with patients undergoing indication biopsies compared with protocol biopsies (odds ratio [OR] 2.27, P = .012). Patient factors associated with major bleeding complications in multivariate models included estimated glomerular filtration rate (OR 0.61, P = .016) and platelet count (OR 0.64, P = .033). Aspirin use was not significantly associated with increased risk of bleeding complication except for use of 325 mg of aspirin within 3 days of biopsy (any complication OR 3.87 [1.12, 13.4], P = .032; major complication OR 6.30 [1.27, 31.3], P = .024).

CONCLUSIONS:

Renal allograft biopsy bleeding complications are very rare, particularly for protocol biopsies. Use of 325 mg of aspirin within 3 days of renal allograft biopsy was associated with increased bleeding complications.

PMID:
27993506
PMCID:
PMC5258683
DOI:
10.1016/j.jvir.2016.10.021
[Indexed for MEDLINE]
Free PMC Article

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