Differential diagnosis of kidney transplant rejection and cyclosporin/tacrolimus nephropathy using urine cytology.
A total of 9000 urine samples from 69 kidney transplant recipients were studied for differential diagnoses of transplant rejection and cyclosporin/tacrolimus toxicity. New-Sternheimer and Papanicolaou staining were used to differentiate cells in urine. We also employed an immunocytochemical technique for further identification of exfoliated cells. With New-Sternheimer and Papanicolaou staining, the predominance of proximal tubular cells was useful to differentiate cyclosporin/tacrolimus toxicity from acute rejection in cases of increased serum creatinine level. During rejection episodes, an increased number of mononuclear cells and renal epithelial cells were found. Immunocytochemical analysis showed a significant increase of CD2-, CD4- CD8-, CD25- and HLA-DR-positive cells with rejection. However, there was no relationship between Banff criteria rejection grade and the increase of mononuclear cells.
Kyo
Masahiro
M
Sakurabashi Circulatory Organ Clinic, Umeda 1-3-1-1100, Kitaku, Osaka, 530-0001, Japan. kyo-m@mwd.biglobe.ne.jp
Toki
Kiyohide
K
Nishimura
Kennichi
K
Fukunishi
Takanobu
T
Nagano
Shunsuke
S
Namba
Yukiomi
Y
Gudat
Fred
F
Dalquen
Peter
P
Mihatsch
M J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016572:Cyclosporine / Q000633:toxicity*; D003584:Cytological Techniques; D003937:Diagnosis, Differential; D006084:Graft Rejection / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D007166:Immunosuppressive Agents / Q000633:toxicity*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000652:urine; D016030:Kidney Transplantation; D007963:Leukocytes, Mononuclear / Q000166:cytology; D008875:Middle Aged; D016559:Tacrolimus / Q000633:toxicity*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus