Prophylactic Intravenous Access: Is it necessary for renal transplant biopsies?

Abstract This retrospective analysis addresses the necessity for prophylactic intravenous (IV) access for routine renal transplant biopsies. In this study, complications that occurred during and up to seven days after routine renal transplant biopsies were analyzed in IV (n=1318) and no-IV (n=492) cohorts. The results demonstrated that the rate of complications requiring peripheral IV access was less than 1% in both cohorts. There were 6 (0.46%) major and 7 (0.53%) minor complications in the IV cohort, and 4 (0.8%) major and 1 (0.2%) minor complications in the no-IV cohort. One complication of hypertensive urgency in the IV cohort was likely related to multiple failed attempts to place a peripheral IV prior to biopsy. One major complication of hypotension in the no-IV cohort was confounded by the presence of bacteremia. For complications that occurred in the no-IV cohort, there was no retrospective evidence to suggest that a significant delay in care occurred due to the lack of IV access at the time of biopsy. These findings allowed us to improve overall departmental efficiency, without significantly changing the rate of biopsy complications.