Bone marrow biopsy in patients with renal transplant: spectrum of findings and diagnostic use

• Published in: Experimental and clinical transplantation Vol. 13 Suppl 1; no. Supplement 1; p. 263
• Main Authors: Börcek, Pelin, Özdemir, B Handan, Akar Özkan, Eylem, Taşlıca, F Zeynep, Haberal, Mehmet
• Format: Journal Article
• Language: English
• Published: Turkey 01-04-2015
• Subjects: Adolescent; Adrenal Cortex Hormones - therapeutic use; Adult; Aged; Biopsy; Bone Marrow Diseases - etiology; Bone Marrow Diseases - pathology; Bone Marrow Examination; Bone Marrow Neoplasms - etiology; Bone Marrow Neoplasms - pathology; Child; Child, Preschool; Female; Fever of Unknown Origin - etiology; Fever of Unknown Origin - pathology; Humans; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - adverse effects; Male; Middle Aged; Predictive Value of Tests; Risk Factors; Time Factors; Treatment Outcome; Turkey; Young Adult; Turkey
• ISSN: 1304-0855; 2146-8427
• DOI: 10.6002/ect.mesot2014.P69

Renal transplant may be complicated by cytopenia, fever of unknown etiology, or hematolymphoid malignancies. Bone marrow biopsy may be indicated to evaluate these complications. However, to the best of our knowledge, no previous study has systematically documented the characteristics of bone marrow biopsy in these patients. The present study reports the range of bone marrow findings in renal transplant recipients.
We selected 85 patients who underwent bone marrow biopsy among 1745 renal transplant recipients who had transplant at Ba şkent University from January 1990 to December 2013. The files of these patients were reviewed for age, sex, age at renal transplant, underlying renal disease, donor type, immunosuppressive therapy, presence or absence of acute humoral or cellular rejection, duration between transplant and bone marrow biopsy, indication for bone marrow biopsy, and histopathologic diagnoses of bone marrow biopsies.
The most common cause of renal insufficiency leading to transplant in this patient group was unknown etiology, observed in 24 patients (28.2%). The most common indication for bone marrow biopsy was blood cytopenia, detected in 56 patients (65.9%). Neoplastic involvement of the bone marrow was detected in 6 patients (7.1%), all of which were hematolymphoid malignancies. Corticosteroids were the most commonly used immunosuppressive agents, administered to all patients.
Bone marrow biopsy provides important information in renal transplant recipients, especially in cases of neoplastic bone marrow involvement, specific inflammation, and amyloidosis, which are uncommon in this patient group. The overall diagnostic use is related to the individual situation of each patient.