OBJECTIVE:

To determine factors associated with complications in patients undergoing renal transplant biopsy.

PATIENTS AND METHODS:

A total of 210 consecutive renal transplant patients biopsied for acute graft dysfunction or as part of a long term surveillance programme. Biopsies were performed under ultrasound control at two centres (Nottingham City and Leicester General Hospitals).

RESULTS:

Seventeen patients developed macroscopic haematuria following biopsy (8%). There were no graft losses. In cases where at least one biopsy core contained only renal medullary tissue, there was a significantly higher risk of a post-biopsy bleed (P < 0.001).

CONCLUSION:

This study demonstrates that even with careful ultrasound guidance, renal transplant biopsy has an important complication rate. Every effort must be made to obtain very superficial biopsies which consist largely or exclusively of renal cortex.