title: [Value of urinary cytology findings in the diagnosis of acute renal graft rejection].
abstract: BACKGROUND
  Acute rejection of allograft is one of the most serious complications of renal transplantation that requires fast and precise diagnostic approach. In this paper our experience in cytologic urinalysis as a diagnostic method of the acute renal allograft rejection was reviewed.
  
  
  METHODS
  The study group included 20 of 56 patients with transplanted kidneys who were assumed for the acute allograft rejection according to allograft dysfunction and/or urine cytology findings. Histological findings confirmed allograft rejection in 4 patients. Urine sediment obtained in cytocentrifuge was air-dried and stained with May-Grunwald-Giemsa. Acute allograft rejection was suspected if in 10 fields under high magnification 15 or more lymphocytes with renal tubular cells were found.
  
  
  RESULTS
  Acute transplant rejection occurred in 32.1% patients. In 15 patients clinical findings of the acute renal allograft rejection corresponded with cytological and histological findings (in the cases in which it was performed). Three patients with clinical signs of the acute allograft rejection were without cytological confirmation, and in 2 patients cytological findings pointed to the acute rejection, but allograft dysfunction was of different etiology (acute tubular necrosis, cyclosporine nephrotoxicity). In patients with clinical, cytological and histological findings of the acute allograft rejection urine finding consisted of 58% lymphocytes, 34% neutrophilic leucocytes and 8% monocytes/macrophages on the average. The accuracy of cytologic urinalysis related to clinical and histological finding was 75%.
  
  
  CONCLUSIONS
  Urine cytology as the reliable, noninvasive, fast and simple method is appropriate as the a first diagnostic line of renal allograft dysfunction, as well as for monitoring of the graft function.
authors.affiliation: Vojnomedicinska akademija, ZPM-Institut za patologiju, Beograd. zaljkat@sezampro.yu
authors.forename: Zeljka
authors.initials: Z
authors.lastname: Tatomirović
authors.forename: Radojka
authors.initials: R
authors.lastname: Bokun
authors.forename: Jovan
authors.initials: J
authors.lastname: Dimitrijević
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Ignjatović
authors.forename: Anastasija
authors.initials: A
authors.lastname: Aleksić
authors.forename: Rajko
authors.initials: R
authors.lastname: Hrvacević
mesh_terms: D000208:Acute Disease; D003581:Cytodiagnosis; D006084:Graft Rejection / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D016030:Kidney Transplantation; D014556:Urine / Q000166:cytology*
vernacular_title: Vrednost nalaza citoloskog pregleda urina u dijagnozi akutnog odbacivanja transplantovanog bubrega.