Use of ultrasound for renal allograft biopsy.

Biopsy of the transplanted kidney may provide useful diagnostic and prognostic information [ljJ. Several biopsy methods have been developed to minimize the risk of damaging the solitary functioning renal allograft. Each method has inherent advantages and disadvantages. Recently, ultrasonography has provided a safe and efficient means of guidance for biopsy of native kidneys [2-6]. Because of prior difficulties with both open and blind percutaneous allograft biopsy methods, we have performed transplant biopsies with the aid of ultrasonographic localization since 1976. We report here the procedure used and the results of the last 50 biopsies performed with this technique. Renal allograft biopsies were performed (1) to confirm the diagnosis or assess the response to treatment of acute rejection episodes with atypical" presentations; (2) to diagnose the etiology of unexplained heavy proteinuria; (3) to confirm the absence of rejection in patients with prolonged allograft dysfunction attributed to acute tubular necrosis; (4) to distinguish chronic rejection from superimposed reversible causes of acute renal deterioration.