Differential diagnosis of kidney transplant rejection and cyclosporin/tacrolimus nephropathy using urine cytology |
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| Authors: | Masahiro Kyo,Yasuji Ichikawa,Kiyohide Toki,Kennichi Nishimura,Takanobu Fukunishi,Shunsuke Nagano,Yukiomi Namba,Fred Gudat,Peter Dalquen, M J Mihatsch |
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| Affiliation: | Sakurabashi Circulatory Organ Clinic, Umeda 1-3-1-1100, Kitaku, Osaka, 530-0001, Japan,;Department of Urology and Renal Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Japan,;Department of Urology, Osaka University School of Medicine, Osaka, Japan, and;Institute of Pathology, University of Basel, Basel, Switzerland |
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| Abstract: | Abstract: 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. |
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| Keywords: | cyclosporin/tacrolimus nephropathy kidney transplant rejection New–Sternheimer staining urine cytology |
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