Immunosuppression and the occurrence of HPV in kidney transplant patients verified by urinary cytology

Leon, Rogéria M.; Ranzi, Alana Durayski; Fardin, Graziele Silveira; Keitel, Elizete; Brackmann, Rosicler Luzia; Prolla, João Carlos; Bica, Cláudia Giuliano

doi:10.5935/1676-2444.20160009

Cited by 3 publications

(6 citation statements)

References 18 publications

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“…Immunosuppression, antirejection therapy, inflammation, and tissue injury are conditions that can contribute to viral reactivation after transplantation. 1,2 We found DCs in 25 samples (9.9%) from six patients (23.1 %). Decoy cell shedding in kidney transplant varies between 17.9% and 28.6% of the patients, in different studies, 6,[15][16][17][18][19] with the first detection around the second and third months after transplantation 16,17 up to the fourth month after transplantation.…”

Section: Discussionmentioning

confidence: 77%

“…Renal transplant patients are exposed to the action of several pathogens due to their immunosuppressive state. 1,2 Infections can cause chronic dysfunction and loss of graft. 3,4 Urine cytology is a noninvasive and low-cost technique that favors serial examinations.…”

Section: Introductionmentioning

confidence: 99%

“…are other pathogens that can be effectively diagnosed in urine by sediment exam. 2,8,12,13 However, nowadays, urinary cytology has been less explored in transplant centers, possibly due to the greater accessibility to molecular diagnostic techniques.Our objective is to investigate urinary cytopathological findings in a group of patients, during their first year after kidney transplantation.…”

Section: Introductionmentioning

confidence: 99%

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Is There Still a Role for Urine Cytology in Kidney Transplantation? Experience Report in a Teaching Hospital

Gouvêa,

Carvalho,

Nascimento

et al. 2023

BJT

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Introduction: Urinary cytology has been used as a monitoring strategy for kidney transplant patients, live under chronic immunosuppression, as it is a non-invasive and low-cost method. The early detection of infections can prevent possible dysfunction and graft loss. However, its use has been decreased. Methods: We conducted a prospective study on voided urine samples from 29 consecutive patients undergoing kidney transplantation over a continuous period of 17 months, collected during their first-year post-transplantation. One technician prepared the samples by cytocentrifugation, Papanicolaou staining, and one pathologist analyzed them. Decoy cells (DCs) positive samples were prepared, by other two technicians, for contrast phase analysis, ultrastructural study, and immunofluorescence for SV40 T antigen. Results: We evaluated 252 urine samples from 26 patients. Two consecutive samples (0.8%) out of five, from the same patient (3.8%), referring to the fourth- and fifth-week post-transplant, showed low-grade squamous intraepithelial lesions; only rare epithelial cells with atypia of undetermined significance were detected (0.4%) in the sample corresponding to the sixth month post-transplant. The patient’s subsequent gynecological examination and Pap smear revealed no changes. Pseudohyphae and fungus yeasts were found in five samples (2.0%) from four patients (15.4%). Trichosporon sp. was identified in the urine of one of these patients. Decoy cells were detected in 25 samples (9.9 %) from six patients (23.1%). Two patients had sustained DCs shedding; one of them, presenting dirty background smears, developed Polyomavirus-associated nephropathy. Ultrastructural study of DCs showed icosahedral viral particles. Immunofluorescence (SV40 T antigen) was positive in DCs nuclei. Analysis by contrast phase was successful in samples with numerous DCs. Conclusion: Systematic urinary cytology after transplantation helps detect some infection signs. Patients with sustained DCs shedding and dirty background smears deserve special clinical attention. Electron microscopy and immunofluorescence (SV40 T antigen) are alternative techniques to detect polyomavirus reactivation. The findings suggest that urinary cytology still plays a role in kidney transplantation.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is There Still a Role for Urine Cytology in Kidney Transplantation? Experience Report in a Teaching Hospital

Gouvêa,

Carvalho,

Nascimento

et al. 2023

BJT

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“…Os pacientes transplantados renais estão expostos à ação de diversos patógenos devido ao seu estado de imunossupressão. 1,2 As infecções podem causar disfunção crônica e perda do enxerto. 3,4 A citologia de urina é uma técnica não invasiva e de baixo custo que favorece a realização de exames seriados.…”

Section: Introductionunclassified

“…são outros patógenos que podem ser diagnosticados com eficácia na urina por meio do exame do sedimento. 2,8,12,13 No entanto, atualmente, a citologia urinária tem sido menos explorada nos centros de transplante, possivelmente devido à maior acessibilidade às técnicas de diagnóstico molecular. Nosso objetivo é investigar os achados citopatológicos urinários em um grupo de pacientes, durante o primeiro ano após o transplante renal.…”

Section: Introductionunclassified

Existe Ainda um Papel para a Citologia Urinária no Transplante Renal? Relato de Experiência em um Hospital Universitário

Gouvêa,

Carvalho,

Nascimento

et al. 2023

BJT

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Introdução: A citologia urinária tem sido utilizada como estratégia de monitoramento dos pacientes transplantados renais, que vivem sob crônica imunossupressão, por ser um método não invasivo e de baixo custo. A detecção precoce de infecções pode prevenir possíveis disfunções e perda do enxerto. No entanto, a sua utilização tem decrescido. Métodos: Realizamos um estudo prospectivo em amostras de urina provenientes de 29 pacientes consecutivos, submetidos ao transplante renal ao longo de um período contínuo de 17 meses, coletadas durante seu primeiro ano pós-transplante. Um mesmo técnico preparou as amostras por citocentrifugação, coloração de Papanicolaou e um único patologista as analisou. Amostras positivas para “decoy cells” (DCs) foram preparadas por dois outros técnicos, para análise por microscopia de contraste de fase, estudo ultraestrutural e imunofluorescência (antígeno T SV40). Resultados: Foram avaliadas 252 amostras de urina de 26 pacientes. Duas amostras consecutivas (0,8%) dentre cinco, de uma mesma paciente (3,8%), referentes à quarta e quinta semana pós-transplante, apresentaram lesão intraepitelial escamosa de baixo grau; na amostra referente ao sexto mês pós-transplante foram detectadas apenas raras células epiteliais com atipias de significado indeterminado (0,4%); o posterior exame ginecológico da paciente e teste de Papanicolaou não revelaram alterações. Pseudohifas e esporos fúngicos foram encontrados em cinco amostras (2,0%) de quatro pacientes (15,4%). Trichosporon sp. foi identificado na urina de um desses pacientes. Decoy cells foram detectadas em 25 amostras (9,9%) de seis pacientes (23,1%). Dois pacientes tiveram eliminação sustentada de DCs; um deles, apresentando esfregaço de fundo sujo, desenvolveu Nefropatia associada ao poliomavírus. O estudo ultraestrutural das DCs mostrou partículas virais icosaédricas. A imunofluorescência (antígeno T SV40) foi positiva nos núcleos das DCs. A análise por microscopia de contraste de fase foi bem-sucedida em amostras com numerosas DCs. Conclusão: A citologia urinária sistemática após o transplante é útil na detecção de alguns sinais de infecção. Pacientes com eliminação sustentada de DCs e esfregaços de fundo sujo merecem atenção clínica especial. A microscopia eletrônica e a imunofluorescência (antígeno T SV40) são técnicas alternativas para detectar a reativação do poliomavírus. Os resultados sugerem que a citologia urinária ainda desempenha um papel no transplante renal.

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HPV-Associated Anal Cancer Knowledge, Attitudes, and Health Communication Behaviors Among Non-clinical Providers at HIV/AIDS Service Organizations in Southern United States Region

Olusanya

Tomar

Thomas³

et al. 2021

J Canc Educ

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Immunosuppression and the occurrence of HPV in kidney transplant patients verified by urinary cytology

Cited by 3 publications

References 18 publications

Is There Still a Role for Urine Cytology in Kidney Transplantation? Experience Report in a Teaching Hospital

Is There Still a Role for Urine Cytology in Kidney Transplantation? Experience Report in a Teaching Hospital

Existe Ainda um Papel para a Citologia Urinária no Transplante Renal? Relato de Experiência em um Hospital Universitário

HPV-Associated Anal Cancer Knowledge, Attitudes, and Health Communication Behaviors Among Non-clinical Providers at HIV/AIDS Service Organizations in Southern United States Region

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