title: Confirmation of the utility of fine needle aspiration biopsy of the renal allograft.
abstract: Allograft immunobiologic theory would predict that analysis of immunocompetent cells infiltrating the renal transplant would be most instructive. Recently a new aspiration biopsy technique has been developed to permit such analysis in patients which can be safely and repetitively performed. The clinical utility of such a technique has been tested utilizing a randomized prospective trial in which an aspirate was obtained every other day from the third post-operative day until discharge. Analysis included examination of adequacy criteria and the capacity of pathologic diagnosis to corroborate clinical diagnosis from coded specimens. Ninety-six aspirates from 21 consenting transplant recipients were obtained and analyzed. In 94 instances a clinical diagnosis could be made; 80 aspirates fulfilled adequacy criteria. We found the technique to be highly sensitive (greater than or equal to 90%) and highly specific (greater than or equal to 90%) for the clinical diagnoses of acute allograft rejection, post-operative acute renal failure, cyclosporine toxicity, and normal function. We conclude that the fine needle aspiration technique is an important adjunct to analysis of clinical renal transplantation and offers a major advantage to the clinical scholar in understanding transplant biology.
mesh_terms: D058186:Acute Kidney Injury / Q000473:pathology*; D001707:Biopsy, Needle; D002986:Clinical Trials as Topic; D003524:Cyclosporins / Q000009:adverse effects*; D006084:Graft Rejection; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D011446:Prospective Studies; D011897:Random Allocation
chemical_list: D003524:Cyclosporins