Fine-needle aspiration biopsy allows early detection of acute rejection inchildren after renal transplantation

Citation
M. Their et al., Fine-needle aspiration biopsy allows early detection of acute rejection inchildren after renal transplantation, TRANSPLANT, 71(6), 2001, pp. 736-743
Citations number
23
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
TRANSPLANTATION
ISSN journal
00411337 → ACNP
Volume
71
Issue
6
Year of publication
2001
Pages
736 - 743
Database
ISI
SICI code
0041-1337(20010327)71:6<736:FABAED>2.0.ZU;2-W
Abstract
Background. Acute rejection is still a major diagnostic problem after renal transplantation and remains an important cause of graft loss. Diagnosis of acute rejection is mainly based on clinical signs and the renal core biops y findings. In adults fine-needle aspiration biopsy (FNAB) has proved to be a sensitive method in diagnosing acute rejection. Methods. In this study we retrospectively analyzed our data on the routine use of FNAB after 83 kidney transplantations in 78 children of different ag es. Results. A total of 984 FNABs were taken during the postoperative hospitali zation with a mean of 12 biopsies per patient. Of the biopsies 93% were rep resentative, and no major complications occurred. Sixty-five rejection epis odes were diagnosed and treated in 47 patients (57%). The FNAB analysis det ected rejections often before clinical signs. Half of the patients had incr eased serum creatinine concentration and 38% had fever at the time of rejec tion diagnosis. Both signs were present in only 19% of the episodes. A decr ease in urine output (> 20%) was seen in a third of the episodes. The rejec tions responded well to oral methylprednisolone (3 mg/kg/day), and lymphogl obulins were needed in only 12% of the episodes. More than 90% of the rejec tions were completely reversible and no transplant was lost because of acut e rejection. Conclusion. The results indicate that FNAB is a safe and sensitive method f or the diagnosis and follow-up of acute cellular rejection in pediatric rec ipients of different ages.