scholarly journals The value of urine cytologic examination findings in the diagnosis of the acute renal allograft rejection

2003 ◽  
Vol 60 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Zeljka Tatomirovic ◽  
Radojka Bokun ◽  
Jovan Dimitrijevic ◽  
Ljiljana Ignjatovic ◽  
Anastasija Aleksic ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Allograft Rejection ◽  
Renal Allograft ◽  
Urine Cytology ◽  
Acute Allograft Rejection ◽  
Histological Findings ◽  
Renal Allograft Rejection ◽  
Renal Tubular Cells ◽  
Allograft Dysfunction ◽  
Acute Renal Allograft Rejection

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 occured 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%. Conclusion. 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.

scholarly journals Renal epithelial cells retain primary cilia during human acute renal allograft rejection injury

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Elizabeth Verghese ◽  
Luciano G. Martelotto ◽  
Jason E. Cain ◽  
Timothy M. Williams ◽  
Andrea F. Wise ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Acute Rejection ◽  
Allograft Rejection ◽  
Primary Cilia ◽  
Renal Allograft ◽  
Collecting Duct ◽  
Hedgehog Signalling ◽  
Renal Allografts ◽  
Renal Allograft Rejection ◽  
Acute Renal Allograft Rejection

Abstract Objectives Primary cilia are sensory organelles which co-ordinate several developmental/repair pathways including hedgehog signalling. Studies of human renal allografts suffering acute tubular necrosis have shown that length of primary cilia borne by epithelial cells doubles throughout the nephron and collecting duct, and then normalises as renal function returns. Conversely the loss of primary cilia has been reported in chronic allograft rejection and linked to defective hedgehog signalling. We investigated the fate of primary cilia in renal allografts suffering acute rejection. Results Here we observed that in renal allografts undergoing acute rejection, primary cilia were retained, with their length increasing 1 week after transplantation and remaining elevated. We used a mouse model of acute renal injury to demonstrate that elongated renal primary cilia in the injured renal tubule show evidence of smoothened accumulation, a biomarker for activation of hedgehog signalling. We conclude that primary cilium-mediated activation of hedgehog signalling is still possible during the acute phase of renal allograft rejection.

scholarly journals Longitudinal Analysis of Whole Blood Transcriptomes to Explore Molecular Signatures Associated with Acute Renal Allograft Rejection

2014 ◽  
Vol 8 ◽  
pp. BBI.S13376 ◽  
Author(s):  
Heesun Shin ◽  
Oliver GÜnther ◽  
Zsuzsanna Hollander ◽  
Janet E. Wilson-Mcmanus ◽  
Raymond T. Ng ◽  
...  
Keyword(s):  
Gene Expression ◽  
Acute Rejection ◽  
Whole Blood ◽  
Allograft Rejection ◽  
Time Course ◽  
Renal Allograft ◽  
Acute Rejection Episode ◽  
Renal Allograft Rejection ◽  
Expression Signature ◽  
Acute Renal Allograft Rejection

In this study, we explored a time course of peripheral whole blood transcriptomes from kidney transplantation patients who either experienced an acute rejection episode or did not in order to better delineate the immunological and biological processes measureable in blood leukocytes that are associated with acute renal allograft rejection. Using microarrays, we generated gene expression data from 24 acute rejectors and 24 nonrejectors. We filtered the data to obtain the most unambiguous and robustly expressing probe sets and selected a subset of patients with the clearest phenotype. We then performed a data-driven exploratory analysis using data reduction and differential gene expression analysis tools in order to reveal gene expression signatures associated with acute allograft rejection. Using a template-matching algorithm, we then expanded our analysis to include time course data, identifying genes whose expression is modulated leading up to acute rejection. We have identified molecular phenotypes associated with acute renal allograft rejection, including a significantly upregulated signature of neutrophil activation and accumulation following transplant surgery that is common to both acute rejectors and nonrejectors. Our analysis shows that this expression signature appears to stabilize over time in nonrejectors but persists in patients who go on to reject the transplanted organ. In addition, we describe an expression signature characteristic of lymphocyte activity and proliferation. This lymphocyte signature is significantly downregulated in both acute rejectors and nonrejectors following surgery; however, patients who go on to reject the organ show a persistent downregulation of this signature relative to the neutrophil signature.

scholarly journals The significance of cytologic examination of urine in the diagnosis of renal allograft dysfunction

2003 ◽  
Vol 60 (3) ◽  
pp. 299-304
Author(s):  
Zeljka Tatomirovic ◽  
Radojka Bokun ◽  
Ljljana Ignjatovic ◽  
Anastasija Aleksic ◽  
Vesna Skuletic ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Acute Tubular Necrosis ◽  
Allograft Rejection ◽  
Renal Allograft ◽  
Acute Allograft Rejection ◽  
Urine Sediment ◽  
Cytologic Examination ◽  
Allograft Dysfunction ◽  
Tubular Necrosis ◽  
Cyclosporine Nephrotoxicity

Background. This paper presents our experience with cytologic examination of urine in diagnosing renal allograft dysfunction. Methods. The study group included 23 patients with renal allograft dysfunction, selected from 56 patients who underwent renal transplantation. Etiologic diagnosis was made according to the clinical picture, histological findings during allograft biopsy, and cytologic examination of urine. Urine sediment was obtained in cytocentrifuge and was air dried and stained with May Grunwald Giemsa. Results. Out of 23 patients with allograft dysfunction in 18 (78.3%) patient it was caused by acute rejection, and in 5 (8.9%) patients by allograft infarction, cyclosporine nephrotoxicity, acute tubular necrosis and chronic nephropathy. In eighteen patients (78.3%) cytologic examination of urine was pathologic, while in 16 (70%) clinical and histology findings coincided with urine cytology findings. Out of 18 patients with acute allograft rejection in 15 patients cytologic examination of urine coincided with acute rejection. Out of 7 patients with expressed cyclosporine nephrotoxicity, in 5 cytologic examination of urine confirmed the cause of allograft dysfunction, as well as in one of 2 patients with acute tubular necrosis. Cytologic examination of urine indicated parenchymal damage in 2 patients with reccurent disease (membranoproliferative and focal sclerosing glomerulonephritis). In 4 of 5 patients suffering from chronic rejection in a year?s monitoring period, urine sediment periodically consisted of lymphocytes, neutrophilic leucocytes, monocyte/macrophages, tubular cells and cilindres, without the predominance of any cell type. In 3 patients allograft dysfunction was caused by infective agents (bacteria, fungus cytomegalovirus). Conclusion. Cytologic examination of urine might be an alternative to histological in diagnosing acute allograft rejection and acute tubular necrosis or nephtotoxicity. Also it might indicate parenchymal disease while the importance of urine cytology in chronic allograft nephropathy needs to be investigated further.

scholarly journals Determinants of Hypofiltration during Acute Renal Allograft Rejection

2002 ◽  
Vol 13 (3) ◽  
pp. 773-778
Author(s):  
Alkesh Jani ◽  
Catherine Polhemus ◽  
Geraldine Corrigan ◽  
Osun Kwon ◽  
Bryan D. Myers ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Morphometric Analysis ◽  
Allograft Rejection ◽  
Renal Allograft ◽  
Control Group ◽  
Hydraulic Pressure ◽  
Acid Extraction ◽  
Oncotic Pressure ◽  
Renal Allograft Rejection ◽  
Acute Renal Allograft Rejection

ABSTRACT. This study sought to determine the extent to which GFR is decreased during acute renal allograft rejection in human subjects and to determine the mechanism of the decrease in GFR. Eight patients with biopsy-proven acute rejection were compared with 18 recipients of optimally functioning renal allografts. GFR and renal plasma flow (RPF) were measured as the clearance of inulin and para-aminohippuric acid, respectively. Arterial BP was determined, blood was sampled, and plasma oncotic pressure (πA) was measured. Glomeruli obtained by biopsy during rejection were subjected to morphometric analysis, for determination of Kf. Control morphometric values for healthy glomeruli were provided by 10 living donors from whom biopsies were obtained at the time of organ donation. The subjects in the acute rejection group exhibited a significantly reduced GFR of 17 ± 4 ml/min per 1.73 m2, compared with 72 ± 4 ml/min per 1.73 m2 for control subjects (P < 0.001). With the use of a sensitivity analysis to take into account the unknown para-aminohippuric acid extraction ratio, the RPF rate was calculated to have likely been significantly decreased, by 45 to 70%, in the acute rejection group. Neither the plasma oncotic pressure nor the mean arterial pressure differed between the two groups. Morphometric analysis revealed no difference in the single-nephron Kf values for the acute rejection group, compared with the control group. These results indicate that acute renal allograft rejection causes a profound decrease in GFR, which is attributable to a decrease in RPF alone or in combination with a decrease in the glomerular transcapillary hydraulic pressure gradient (ΔP).

Triple drug Therapy for the Prevention of Early Acute Renal Allograft Rejection in Dogs

2010 ◽  
Vol 41 (1) ◽  
pp. 9-16
Author(s):  
Masaaki KATAYAMA ◽  
Kazuhiro FUKAI ◽  
Hiroyuki IGARASHI ◽  
Kenji TANI ◽  
Yutaka MOMOTA ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Allograft Rejection ◽  
Renal Allograft ◽  
Renal Allograft Rejection ◽  
Acute Renal Allograft Rejection

ROLE OF XANTHINE OXIDOREDUCTASE IN EXPERIMENTAL ACUTE RENAL-ALLOGRAFT REJECTION

2004 ◽  
Vol 77 (11) ◽  
pp. 1683-1692 ◽  
Author(s):  
Kai Sun ◽  
Eva Kiss ◽  
Jens Bedke ◽  
Tomislav Stojanovic ◽  
Yanhua Li ◽  
...  
Keyword(s):  
Allograft Rejection ◽  
Renal Allograft ◽  
Xanthine Oxidoreductase ◽  
Renal Allograft Rejection ◽  
Acute Renal Allograft Rejection

scholarly journals Renal and Urinary Levels of Endothelial Protein C Receptor Correlate with Acute Renal Allograft Rejection

PLoS ONE ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. e64994 ◽  
Author(s):  
Lionel Lattenist ◽  
Jesper Kers ◽  
Nike Claessen ◽  
Ineke J. M. ten Berge ◽  
Frederike J. Bemelman ◽  
...  
Keyword(s):  
Allograft Rejection ◽  
Protein C ◽  
Renal Allograft ◽  
Endothelial Protein C Receptor ◽  
Renal Allograft Rejection ◽  
Acute Renal Allograft Rejection ◽  
Urinary Levels
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