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CHAPTER 5 Renal Allograft Biopsy Wong Hin Seng 5 th MRRB report 2011 & 2012, Malaysia.

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Presentation on theme: "CHAPTER 5 Renal Allograft Biopsy Wong Hin Seng 5 th MRRB report 2011 & 2012, Malaysia."— Presentation transcript:

1 CHAPTER 5 Renal Allograft Biopsy Wong Hin Seng 5 th MRRB report 2011 & 2012, Malaysia

2 Table 5.2.1: Number of renal allograft biopsy, 2005-2012 Year20052006200720082009201020112012Total Number of renal transplant biopsy 761211251261371812392901295 5 th MRRB report 2011 & 2012, Malaysia

3 Figure 5.2.1: Number of renal allograft biopsy, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

4 Table 5.2.2: Number of renal allograft biopsy by centre, 2005-2012 Centre IDCentre 20052006200720082009201020112012Total n%n%n%n%n%n%n%n%n% 00180 Kuala Lumpur3039.55142.24435.23729.44532.94323.84117.23311.432425.0 04380 Selayang (Adult)2026.31915.72217.61511.94129.93720.45322.24314.825019.3 20180 UMMC00.00 3024.02721.485.800.03615.18730.018814.5 126080 Prince Court Medical Centre00.00 0 0 64.44726.05422.67124.517813.8 02081 Kuala Lumpur (Paed)11.31411.697.21713.5128.8105.593.882.8806.2 00780 Tengku Ampuan Rahimah67.9119.1129.6107.996.631.7104.293.1705.4 00480 Penang (Adult)1215.8129.921.654.021.5137.272.993.1624.8 01780 Sarawak General22.621.721.654.032.284.410.441.4272.1 00380 Sultanah Bahiyah00.00 0 32.432.295.031.310.3191.5 20080 PPUKM00.00 0 0 0 0 104.293.1191.5 07781 Sultan Ismail (Paed)00.00 0 21.610.742.241.710.3120.9 01080 Sultanah Aminah00.021.700.021.610.721.110.420.7100.8 00980 Melaka00.021.710.81 00.00 31.320.79 00880 Tuanku Ja'afar Hospital00.010.81 1 21.500.010.420.780.6 00580 Raja Permaisuri Bainun11.321.721.600.00 0 0 10.360.5 108180 Serdang00.00 0 0 32.210.600.031.070.5 01480 Queen Elizabeth45.332.500.00 0 0 0 0 70.5 02380 Sultanah Fatimah00.00 0 0 0 10.620.810.34 00481 Penang (Paed)00.010.800.00 0 0 0 10.320.2 04381 Selayang (Paed)00.010.800.00 0 10.600.00 20.2 61080 Normah Medical Specialist Centre00.00 0 0 0 0 20.800.020.2 61280 Fan Medical Renal Clinic00.00 0 0 0 10.600.010.320.2 65880 KPJ Ampang Puteri Specialist00.00 0 10.800.010.610.400.030.2 01180 Tengku Ampuan Afzan00.00 0 0 0 0 0 10.310.1 01280 Sultanah Nur Zahirah00.00 0 0 0 0 10.400.010.1 01380 Raja Perempuan Zainab II00.00 0 0 10.700.00 0 10.1 62480 Loh Guan Lye Specialist Centre00.00 0 0 0 0 0 10.310.1 Total76100.0121100.0125100.0126100.0137100.0181100.0239100.0290100.01295100.0 UMMC: University Malaya Medical Centre. PPUKM: Pusat Perubatan Universiti Kebangsaan Malaysia 5 th MRRB report 2011 & 2012, Malaysia

5 Table 5.2.3: Renal allograft biopsy by year and age group, rate per million populations, 2005-2012 Age group 20052006200720082009201020112012Total n%Raten% n% n% n% n% n% n% n% <1500.0 65.00.175.60.197.10.196.60.184.40.193.80.182.80.1564.30.1 15-<251621.10.32621.50.51915.20.42318.30.41511.00.32111.60.43414.20.6217.20.417513.50.5 25-<351114.50.22520.70.61512.00.32015.90.43223.40.73016.60.63615.10.87826.91.624719.10.8 35-<452532.90.72722.30.74939.21.22519.80.62619.00.66636.51.68636.02.17726.61.838129.41.4 45-<551418.40.52520.70.92419.20.83527.81.13827.71.24022.11.24418.41.36923.82.028922.31.4 55-<65810.50.586.60.5118.80.7107.90.61611.70.9126.60.62912.11.43311.41.51279.81.0 > 6522.60.243.30.300.0 43.20.310.70.142.20.310.40.141.40.3201.50.2 Total76100.00.3121100.00.5125100.00.5126100.00.5137100.00.5181100.00.6239100.00.8290100.01.01295100.00.7 5 th MRRB report 2011 & 2012, Malaysia

6 Figure 5.2.3: Renal allograft biopsy by year and age group, rate per million populations, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

7 Table 5.3.1: Indications for renal allograft biopsy, 2005-2012 Current clinical presentation 20052006200720082009201020112012 n%n%n%n%n%n%n%n% Urine abnormality 11.332.421.6108.0139.652.9167.7218.7 Nephrotic syndrome 00.032.432.500.021.510.621.010.4 Gross hematuria 00.00 10.81 10.700.00 10.4 Acute deterioration of graft function 4154.75544.45545.14334.74130.14827.94923.44317.8 Creeping creatinine 2634.75241.94234.45645.25641.210460.511354.116066.1 Non/Poor delayed graft function 79.3118.91814.81411.32115.4137.62712.9156.2 Missing/Not available 00.00 10.800.021.510.621.010.4 Total75100.0124100.0122100.0124100.0136100.0172100.1209100.1242100.0 5 th MRRB report 2011 & 2012, Malaysia

8 Figure 5.3.1: Indications for renal allograft biopsy, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

9 Table 5.4: Timing of renal allograft biopsy, 2005- 2012 (dates: date of biopsy & date of transplant) Timing of renal transplant biopsy Within 1 week >1 week to 1 month > 1month to 3 months > 3 months to 6 months > 6months to 1 year >1 yr post transplant Total n%n%n%n%n%n%n% 200522.6911.8810.51317.167.9385076100 200654.11512.41310.797.49 7057.9121100 2007541411.2151210886.47358.4125100 200864.81310.31713.586.4118.77156.4126100 200953.71611.72316.896.664.47856.9137100 201063.34122.72815.52111.6137.27239.8181100 2011114.64117.23615.13313.81989941.4239100 201272.44716.25820321126912041.4290100 Total473.619615.119815.313510.4987.6621481295100 5 th MRRB report 2011 & 2012, Malaysia

10 Figure 5.4: Timing of renal allograft biopsy, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

11 Table 5.5.1: Biopsy method, 2005-2012 Method 20052006200720082009201020112012Total n%n%n%n%n%n%n%n%n% Blind (not US guided) 11.400.011.300.00 0 21.100.040.4 US guided: real-time 2838.46456.66683.58389.210190.211076.916084.715485.176677.9 US guided: not real- time 3547.93430.156.344.398.03021.02211.62413.316316.6 Missing*912.31513.378.966.521.832.152.631.7505.1 Total73100.0113100.079100.093100.0112100.0143100.0189100.0181100.0983100.0 *No data on biopsy technique 5 th MRRB report 2011 & 2012, Malaysia

12 Figure 5.5.1: Biopsy method (censored for missing data), 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

13 Table 5.5.2: Number of passes, 2005-2012 Number of passes 20052006200720082009201020112012Total n%n%n%n%n%n%n%n%n% 12128.84136.32227.831332320.22919.668336936.530429.9 23547.94741.63746.84547.97061.49262.211455.39952.453953.1 379.687.11012.71111.71815.82013.5188.717910910.7 4000011.311.121.842.752.431.6161.6 5000000000021.410.50030.3 6000000000010.7000010.1 Missing/ Not available 1013.71715911.466.410.9000010.5444.3 Total7310011310079100941001141001481002061001891001016100 * No data information on number of passes 5 th MRRB report 2011 & 2012, Malaysia

14 Figure 5.5.2: Number of passes, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

15 Table 5.5.3: Number of glomeruli obtained on biopsy, 2005-2012 Number of glomeruli obtained 20052006200720082009201020112012Total n%n%n%n%n%n%n%n%n% 079.243.375.67 21.5126.6135.472.4594.6 1 - 92330.33226.52318.43830.237275932.66627.68830.336628.3 10 - 193444.75444.65140.858465540.26234.310343.112844.154542.1 >201215.83125.64334.42116.73928.54625.45422.65719.730323.4 Missing/ Unknown*000010.821.642.921.131.3103.5221.7 Total761001211001251001261001371001811002391002901001295100 * No data information on the number of glomeruli 5 th MRRB report 2011 & 2012, Malaysia

16 Figure 5.5.3: Number of glomeruli obtained on biopsy, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

17 Table 5.5.4: Type of complications, 2005-2012 Type of complications 20052006200720082009201020112012Total n%n%n%n%n%n%n%N%n% No complication5779.29887.56986.39096.810291.91329118698.417898.391292.8 Mild complication a 11.4004533.243.685.521.12 242.4 Severe complication b 0010.911.300000010.50030.3 Missing / Unknown c 1419.41311.667.50054.553.40010.6444.5 Total721001121008010093100111100145100189100181100983100 a Mild complication is defined as presence of gross hematuria, perirenal collection, hematoma, or AVM that do not require intervention b Severe complication is defined as presence of hypotension or complications requiring intervention. c No data information for complications 5 th MRRB report 2011 & 2012, Malaysia

18 Table 5.6: Histological diagnosis, 2005-2012 Histological Diagnosis 20052006200720082009201020112012Total n%n%n%n%n%n%n%n%n% Acute rejection3238.16133.06242.85744.55836.78545.510039.811338.356839.6 Borderline rejection 1011.984.364.164.72415.23518.74116.35217.618212.7 Calcineurin inhibitor toxicity 2226.22915.71812.41713.32314.62111.22811.23511.919313.5 Chronic allograft nephropathy 910.74122.22819.31914.8106.384.3104.0186.114310.0 Acute tubular necrosis 910.72211.92013.81814.12314.62412.83012.03812.918412.8 PTLD**00.063.210.700.00 0 10.400.080.6 De novo00.010.521.443.131.910.562.462.0231.6 Recurrent GN22.473.810.732.3106.342.120.851.7342.4 Diabetic nephropathy 00.052.721.410.831.910.552.020.7191.3 Others00.052.753.432.342.584.32811.2268.8795.5 Total84100.0185100.0145100.0128100.0158100.0187100.0251100.0295100.01433100.0 Patients may have more than 1 diagnosis classification **Post Transplant Lymphoproliferative disease 5 th MRRB report 2011 & 2012, Malaysia

19 Figure 5.6: Histological diagnosis, 2005-2012 5 th MRRB report 2011 & 2012, Malaysia

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