Naslov
Urine Immunocytology as a Noninvasive Diagnostic Tool for Acute Kidney Rejection: a Single Center Experience

Autori
Mihovilović, Karlo ; Kardum-Skelin, Ika ; Ljubanović, Danica ; Sabljar-Matovinović, Mirjana ; Vidas, Željko ; Knotek, Mladen

Izvornik
Collegium Antropologicum (0350-6134) 34 (2010), 1; 63-67

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
renal transplantation; acute rejection; immunocytology; urinary sediment

Sažetak
Renal biopsy is a gold standard for establishing diagnosis of acute rejection of the renal allograft. However, being in- vasive, renal biopsy has potential significant complications and contraindications. Therefore, possibility to noninva- sively diagnose acute rejection would improve follow-up of kidney transplant patients. The purpose of this study was to evaluate urine immunocytology for T cells as a method for noninvasive identification of patients with acute renal allo- graft rejection in comparison to renal biopsy. In this prospective study a cohort of 56 kidney, or kidney-pancreas trans- plant recipients was included. Patients either received their transplant at the University Hospital »Merkur«, or have been followed at the »Merkur« Hospital. Patients were subject to either protocol or indication kidney biopsy (a total of 70 biop- sies), with simultaneous urine immunocytology (determination of CD3-positive cells in the urine sediment). Acute rejec- tion was diagnosed in 24 biopsies. 23 episodes were T-cell mediated (6 grade IA, 5 grade IB, 1 grade IIA, 1 grade III and 10 borderline), while in 1 case acute humoral rejection was diagnosed. 46 biopsies did not demonstrate acute rejection. CD3-positive cells were found in 21% of cases with acute rejection and in 13% of cases without rejection (n.s.). A finding of CD3-positive cells in urine had a sensitivity of 21% and specificity of 87% for acute rejection (including borderline), with positive predictive value of 45% and negative predictive value of 68%. Although tubulitis is a hallmark of acute T cell-mediated rejection, detection of T cells in urine sediment was insufficiently sensitive and insufficiently specific for diagnosing acute rejection in our cohort of kidney transplant recipients.

Izvorni jezik
Engleski

Znanstvena područja
Biologija, Temeljne medicinske znanosti, Kliničke medicinske znanosti

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