Monitoring of organ allograft rejection by fine needle aspiration cytology

Häyry, P; Ahonen, J; Willebrand, E von

doi:10.1007/978-94-009-5674-2_9

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…TWO specimens from each sampling episode (liver aspirate and peripheral blood) were processed simultaneously and compared using the total corrected increment (TCI) method of von Willebrand and Hgyry [3] for monitoring renal grafts. Air-dried specimens were stained with May-Grunwald-Giemsa.…”

Section: Processing and Assessmentmentioning

confidence: 99%

The accuracy of aspiration cytology in the diagnosis of rejection following orthotopic liver transplantation

et al. 1988

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The role of aspiration cytology (AC) and the total corrected increment (TCI) in the diagnosis of hepatic rejection was assessed in 30 patients following 36 liver transplants. A total of 174 AC specimens were "blindly" evaluated. Patients underwent protocol AC twice weekly and when biochemical or clinical parameters suggested rejection. Hepatic rejection was only confirmed when clinical and biochemical changes were accompanied by positive histological diagnosis. In all, 103 specimens were matched against histology, the remainder assessed against retrospective clinical and biochemical diagnoses. There were 80 cytological diagnoses of rejection, confirmed in 69 specimens, and 94 diagnoses of no rejection, confirmed in 73 specimens. These figures give a sensitivity of 76.7%, a specificity of 86.9% and a positive predictive value of 86.3%. Overall, 39.7% of specimens taken more than 2 months after grafting proved to be incorrectly diagnosed. However, the accuracy was higher in 145 specimens taken within 8 weeks of transplantation, with a sensitivity of 81.3%, a specificity of 90%, a positive predictive value of 89.7% and an accuracy of 85.5%. Although histology remains the gold standard in the diagnosis of acute rejection after hepatic grafting, AC using a TCI with a positive predictive value of 86.3% may prove to be of value in monitoring liver transplant patients in the first 2 months after grafting.

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Section: Processing and Assessmentmentioning

confidence: 99%

The accuracy of aspiration cytology in the diagnosis of rejection following orthotopic liver transplantation

et al. 1988

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“…Reitimoet al [31] reported that macrophages formed the largest component of infiltrating cells in acute rejection and the finding of an increase in macrophages has been used for the diagnosis of rejection in fine-needle aspiration samples [5], But it has not yet received much attention, probably because of the variability and usually weak staining of renal allograft macrophages with most monocyte/macrophage monoclonal antibodies. It has also not yet be elucidated as to which kind of monoclonal anti body is more specific to rejection and the histologic diag nostic criteria for the rejection reaction have not been established internationally.…”

Section: Discussionmentioning

confidence: 99%

“…Many researchers have also examined cell pop ulations infiltrating in renal allografts by the use of immu nohistochemical methods using monoclonal antibodies [2,3], However, the role of monocvtes/macrophages in allograft rejection has remained unclear. On the other hand, previous studies of murine or human renal allo grafts have shown that an increased expression of class II major histocompatibility antigens (HLA-DR) on tubular epithelial cells have been observed as a marker for the diagnosis of acute rejection [4,5]. In difficult cases, such as viral infection, however, even these markers are not specific enough to yield a definitive diagnosis [6], It is well known that monocytes together with lympho cytes are the first recipient cells infiltrating in the graft.…”

Section: Introductionmentioning

confidence: 99%

An Analysis of Monocyte/Macrophage Subsets and Granulocyte-Macrophage Colony-Stimulating Factor Expression in Renal Allograft Biopsies

Kajiwara

Kawamura²,

Takebayashi³

1996

Nephron

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The role of infiltrating macrophages in the pathogenesis of acute rejection was investigated in biopsy specimens obtained from human transplanted kidneys using immunohistochemical methods. Thirty-one allograft tissue specimens obtained from 26 patients were histologically classified into 18 with acute rejection, 7 with borderline change and 6 with chronic rejection according to the Banff working classification (1993). These specimens were analyzed by avidin-biotin peroxidase complex method on frozen sections in order to examine the utility of some antimonocyte/macrophage monoclonal antibodies in differentiating acute rejection from other conditions. The ratio of CD68, CD11b, LeuM3, OKM5 and HAM56-positive infiltrating monocytes/macrophages to leukocyte common antigen (LCA)-positive cells in the renal cortex were calculated. As a result, the ratio of the positive cells for CD68, which stains mature macrophages, significantly increased in the cases of acute rejection compared with those of other groups. In addition, a strong expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) was observed in the acute rejection group. In our study, the expression of class II major histocompatibility antigens (HLA-DR) in the proximal epithelial tubules was also strongly observed in the cases of acute rejection. It was thus concluded that the increase of CD68-positive infiltrating cells and the expression of GM-CSF may play a possible role as a reaction effector in the process of acute renal allograft rejection.

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“…The relative ratio of the parenchymal cells and leukocytes is determined and a sample in which the number of parenchymal cells is between 10-50 for 100 leukocytes is considered adequate. Further interpretation of the aspirate is also performed as described by Hayry and von Willebrand et al [3][4][5][6] Relative numbers of the various leukocytes (lymphoblasts, plasma cells, lymphocytes, monocytes, macrophages, polymorphonuclear cells) are determined for both the allograft and peripheral blood. For each of these leukocytes, the values obtained from the blood sample are subtracted from those obtained from the allograft sample.…”

Section: Adequacy and Interpretationmentioning

confidence: 99%

“…Disinfect the overlying skin and localize the area of the kidney to be sampled between two fingers. 3. With a 23-gauge 4-cm long pediatric spinal needle, puncture the skin and push the needle gently until it reaches the renal capsule ( Fig.…”

Section: Aspiration Proceduresmentioning

confidence: 99%

Improved technique for fine‐needle sampling of renal allografts

Akhtar

1994

Diagnostic Cytopathology

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Monitoring of organ allograft rejection by fine needle aspiration cytology

Cited by 4 publications

References 17 publications

The accuracy of aspiration cytology in the diagnosis of rejection following orthotopic liver transplantation

The accuracy of aspiration cytology in the diagnosis of rejection following orthotopic liver transplantation

An Analysis of Monocyte/Macrophage Subsets and Granulocyte-Macrophage Colony-Stimulating Factor Expression in Renal Allograft Biopsies

Improved technique for fine‐needle sampling of renal allografts

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