4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta
4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta
4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta
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Clinical Cytology - Plenary and Invited Lectures<br />
URINE IMMUNOCYTOLOGY AS A NONINVASIVE DIAGNOSTIC TOOL FOR ACUTE<br />
KIDNEY REJECTION: A SINGLE CENTER EXPERIENCE<br />
Mihovilović K1 , Kardum-Skelin I1 , Jelić-Puškarić B1 , Ljubanović D2 , Bulimbašić S2 ,<br />
Sabljar-Matovinović M1 , Kovačević-Vojtušek I1 , Gracin S1 , Kocman B1 , Jadrijević S1 ,<br />
Vidas Ž1 , Guštin D1 , Knotek M1 1 Clinical Hospital “Merkur”, Zagreb, Croatia<br />
2 Clinical Hospital “Dubrava”, Zagreb, Croatia<br />
Aim - Renal biopsy is gold standard for diagnosing acute renal allograft rejection. Acute<br />
rejection may be associated with lymphocyte shedding in the urine. The aim of the present<br />
study was to evaluate diagnostic performance of urine immunocytology for CD3positive<br />
cells in diagnosing renal allograft rejection.<br />
Participants and methods - This was a prospective single centre study performed in<br />
Clinical Hospital “Merkur”, Croatia. 54 kidney and kidney-pancreas transplant patients<br />
with 70 kidney biopsies (for cause or by protocol) and simultaneous urine immunocytologies<br />
(immunostaining for CD3) were included.<br />
Results - There were 24 AR cases, while in 46 biopsies AR was absent. Urine sediment<br />
was positive for CD3+ lymphocytes in 5 cases of AR (21%) and in 6 cases without AR (13%).<br />
CD3 positivity had sensitivity of 21%, specificity of 87%, positive predictive value of 45%<br />
and negative predictive value of 68% for diagnosis of AR.<br />
Discussion - These results demonstrate insufficient both sensitivity and specificity of<br />
urine immunocytology for CD3 for establishing diagnosis of renal AR. With respect to<br />
sensitivity our results are at odd with some of the previously published studies. Reasons<br />
for that are unclear, but may reflect either poor intrinsic performance of urine immunocytology<br />
for detection of AR, or may involve several technical factors like small initial<br />
volume of urine for analysis.<br />
Conclusion - Kidney biopsy still remains gold standard for detection AR. Urine immunocytology<br />
may have potential to become one of the methods for detection AR in kidney<br />
transplant patients, if sensitivity and specificity could be improved.<br />
karlomihovilovic@gmail.com<br />
51<br />
4 th <strong>Croatian</strong> <strong>Congress</strong> of Clinical Cytology / 1 st <strong>Croatian</strong> Symposium of Analytical Cytology / 2 nd <strong>Croatian</strong> Symposium of Cytotechnology
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