Kidney Biopsy Complication
Hi Transplant Family!
I hope you are doing well. I just came back from my three year kidney transplant annual visit. My creatinine has increased from my baseline due to a complication from my 4 month protocol biopsy. The stabbing from the biopsy needle formed a fistula within the kidney. To solve this, Intervention Radiology will go in at the groin to inject a chemical to clot off the fistula that formed within the kidney. (It sort of sounds similar to a heart catheterization of the kidney). Has anyone heard of this procedure or experienced a similar procedure?
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@hello1234. I have not heard of this, but keep in mind that I’m a patient with only my experience to rely on.
I am aware that there are always risks of complications associated with invasive procedures. It does sound as if there is a plan in place to remedy this and that is good to hear.
When will you have the injection? Will you be heading back to Mayo for it?
Hi @rosemarya 😊
It is great to hear from you! Yes after I take a few more blood and urine tests locally, the procedure will be scheduled with Intervention Radiology at Mayo Jacksonville.
I am hoping that maybe someone reading this, may know someone that had a successful embolization of a renal av fistula.
Normally, a small fistula within the kidney would resolve itself in 2 years instead of getting larger. Unfortunately, my nephrologist was able to hear it when listening with a stethoscope, which means it's probably not small. My creatinine is increasing so I will probably need to move forward to retain kidney function. It's upsetting and scary, because every procedure has risks.
@hello1234 How scary, right? When I had my biopsies on my native kidneys, there was a laundry list of possible complications. But noone I know of has had a fistula happen as a result of a biopsy.
What chemical will be injected? Any concern it will interfere/interact with your transplant or medications?
Ginger
Hi @gingerw 😊
Thanks so much for joining in! Yes, there is always a long laundry list of possible adverse outcomes to every drug and procedure, but I don't expect any of the bad ones to happen to me. (Especially a procedure that is done so often at a transplant center).
I am not sure what chemical is used to clot off the fistula, but I have been warned that I may lose that portion of the kidney.
My fear is that the longevity of my beautiful new kidney definitely appears to be in jeopardy.
My baseline creatinine was consistently. 9 and is now 1.1.
My 24 hour creatinine clearance was 70 and is now 50.
Sadly, my kidney function is definitely going the wrong direction.
I was hoping this kidney may have taken me to the end, but now I don't think so.
I feel badly that I didn't follow my instinct and say no to the protocol biopsies since the kidney was functioning beautifully.
I like to use biopsies when something actually needs to be diagnosed but my transplant coordinator insisted that I proceed, so I felt I was at risk of being non-compliant. I definitely didn't want to do anything that risked the kidney. And here I am. Scared.
Hi @hello1234, I am so sorry you are going through this. You have had so many things to deal with since your transplant. I didn’t even know this was a thing! I will be having my 3 year visit late this year and was excited anticipating not having a biopsy this time. At least that was in my mind one wouldn’t be needed. How scary! My understanding is we get them to be able to see rejection and treat earlier to have a better outcome. Please keep us updated with how things go. I will be thinking of you and praying all is well. -Jennifer
Hi @jennifer0726 😊
I am so happy to hear from you!
I smiled when you said you didn't even know this was a thing! Me too.
After a kidney transplant, I would always hold my breath until my first pee to make sure there was no no blood in the urine. I thought if there was no blood, I was scott free. No such luck.
I also thought that an ultrasound guided biopsy would pretty much eliminate hitting an artery.
My assumptions appear to be incorrect unfortunately.
I will definitely keep you posted.
Congrats on your upcoming three year anniversary! Hopefully, it will be a nice, boring, uneventful visit! Please keep me posted on your visit when you have it later this year. (You have been through a lot too.) Hopefully, all will be well for both of us.
Love to you 🥰 My fellow 3 year transplant sister!
I’m 4 years out from my 2nd kidney transplant. First one was in 1994. Last year my creatinine got a little higher than my normal 1.4. It was 1.9, but it does tend to fluctuate.
Instead of having a biopsy to check for rejection, my nephrologist had me do a relatively new non-invasive test. It’s a blood test called Prospera. A company called Natera came to my house to draw blood.
It took a few weeks to get the results. There was no sign of rejection. I don’t know if everyone would qualify for this test.
Here is the website for Natera/Prospera:
https://www.natera.com/organ-health/prospera-organ-transplantation-assessment/
Oh, gosh, I hope you don't lose that part of your kidney or your kidney! So scary to be in limbo like this. No matter the when of the procedure, it can't come soon enough, right? Here for you, however I can help.
I have a surgery-created fistula on my right forearm, for hemodialysis. Unfortunately, nine months after the procedure, it "shut down" without notice about a year ago. Fortunately I am on peritoneal dialysis. If needed, they will place a new one further up my arm.
Your transplant coordinator could not have foreseen this complication. Hopefully they have been advised of the situation and will reach out to you.
Ginger
Hi @gingerw 😊
Thank you so much for all your support! You are always one of the first to jump in to help me with my latest challenge. I can't tell you how much I appreciate it.
(No need to alert my transplant coordinator, all is well on that end).
I will definitely keep you posted on my progress!
Hello @tjdog 😊
It's so great to hear from you!
You included excellent information about the new biomarker noninvasive blood tests. Thank you for the link, this is important information for everyone!
I am so happy to hear that you avoided the invasive biopsy and had the blood test instead.
Has your creatinine returned closer to the 1.4 or is it still elevated or bouncing around?
Are they going to continue to search for the cause of the elevated creatinine with an ultrasound or something like that? Or is your team satisfied that it's fluctuating between 1.4 and 1.9 and no biopsy needed?
Thank you again @tjdog 😊 for joining in the discussion!