Thromboelastography for the prediction of bleeding after transplant renal biopsy.

Journal of the American Society of Nephrology : JASN
C L Davis, W L Chandler

Abstract

The ability of prebiopsy coagulation assays to predict mild postbiopsy bleeding was evaluated in renal transplant patients undergoing renal allograft biopsy (N = 120). The coagulation assays studied included the bleeding time, prothrombin time, partial thromboplastin time, platelet count, and thromboelastograph (TEG). Coagulation results were defined as abnormal if they fell outside the established normal reference range. Bleeding was defined as a drop in the hematocrit equal to or more than 4 points 6 h after the procedure or ultrasound evidence of a new perirenal hematoma. Overall, 21% of patients showed evidence of mild bleeding. Of those who bled, 78% had normal results on all coagulation tests, indicating that most mild bleeding was not associated with coagulation abnormalities. Of the assays tested, only abnormal TEG:angle (P < 0.01) and TEG:k (P < 0.04) values were associated with an increased risk of bleeding. Bleeding times were not predictive of an increased risk of postbiopsy bleeding; five patients had abnormal bleeding times ranging from 10 to 20 min of whom only one bled. All prothrombin time, partial thromboplastin time, and platelet count abnormalities were mild (e.g., no prothrombin times longer than 15 s, no p...Continue Reading

Citations

Feb 28, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Connie L DavisAlan H Wilkinson
Sep 1, 2005·Transfusion·Jodi B SegalUNKNOWN Transfusion Medicine/Hemostasis Clinical Trials Network
Jan 30, 2007·Hematology/oncology Clinics of North America·Linda Shore-Lesserson
Jul 11, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·R J McDonaghM J Vermeulen

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