Journal article
Indications, Techniques, and Barriers for Pancreas Transplant Biopsy: A Consensus Perspective From a Survey of US Centers
Transplantation, Vol.108(7), pp.e129-e138
07/2024
DOI: 10.1097/TP.0000000000004960
PMID: 38467588
Abstract
Pancreas transplant biopsy practices for the diagnosis of rejection or other pathologies are not well described.
We conducted a survey of staff at US pancreas transplant programs (March 22, 2022, to August 22, 2022) to assess current program practices and perceptions about the utility and challenges in the performance and interpretation of pancreas allograft biopsies.
Respondents represented 65% (76/117) of active adult pancreas transplant programs, capturing 66% of recent pancreas transplant volume in the United States. Participants were most often nephrologists (52%), followed by surgeons (46%), and other staff (4%). Pancreas allograft biopsies were performed mostly by interventional radiologists (74%), followed by surgeons (11%), nephrologists (8%), and gastroenterologists (1%). Limitations in the radiologist's or biopsy performer's comfort level or expertise to safely perform a biopsy, or to obtain sufficient/adequate samples were the two most common challenges with pancreas transplant biopsies. Pancreas transplant biopsies were read by local pathologists at a majority (86%) of centers. Challenges reported with pancreas biopsy interpretation included poor reliability, lack of reporting of C4d staining, lack of reporting of rejection grading, and inconclusive interpretation of the biopsy. Staff at a third of responding programs (34%) stated that they rarely or never perform pancreas allograft biopsies and treat presumed rejection empirically.
This national survey identified significant variation in clinical practices related to pancreas allograft biopsies and potential barriers to pancreas transplant utilization across the United States. Consideration of strategies to improve program experience with percutaneous pancreas biopsy and to support optimal management of pancreas allograft rejection informed by histology is warranted.
Details
- Title: Subtitle
- Indications, Techniques, and Barriers for Pancreas Transplant Biopsy: A Consensus Perspective From a Survey of US Centers
- Creators
- Neeraj Singh - Willis-Knighton Cancer CenterKrista L Lentine - Saint Louis University HospitalVidya A Fleetwood - Saint Louis University HospitalKenneth J Woodside - Gift of Life MichiganJon Odorico - University of Wisconsin–MadisonDavid Axelrod - University of IowaTarek Alhamad - Washington University in St. LouisKennan Maher - Saint Louis University HospitalHuiling Xiao - Saint Louis University HospitalJonathan Fridell - Indiana University – Purdue University IndianapolisAleksandra Kukla - Mayo Clinic in ArizonaMartha Pavlakis - Beth Israel Deaconess Medical CenterHosein M Shokouh-Amiri - Willis-Knighton Health System, Shreveport, LAGazi Zibari - Willis-Knighton Cancer CenterMatthew Cooper - Medical College of WisconsinRonald F Parsons - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Transplantation, Vol.108(7), pp.e129-e138
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- DOI
- 10.1097/TP.0000000000004960
- PMID
- 38467588
- ISSN
- 0041-1337
- eISSN
- 1534-6080
- Grant note
- Jane A. Beckman Endowed Chair in Transplantation / Mid-America Transplant
- Language
- English
- Electronic publication date
- 03/12/2024
- Date published
- 07/2024
- Academic Unit
- Surgery
- Record Identifier
- 9984572378502771
Metrics
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