[Aspiration cytology in the diagnosis of renal transplant rejection]

The use of fine needle aspiration for the diagnosis of renal transplant rejection is advantageous for its innocuousness, thereby making it an acceptable method for monitoring. However, the clinical use reported among several groups has been variable and indeed, the influence it may have on the results of the use of different lines of immunosuppressors is little known.

Thirty-six consecutive renal transplanted patients were studied prospectively over the 2 months following the transplantation of the organ. The basal immunosuppressor treatment consisted in the administration of prednisone and antilymphocytic serum in patients presenting acute post-transplant tubular necrosis with the remaining patients receiving cyclosporin in monotherapy. One hundred seventy-three double punction were carried out.

No complications were observed as a consequence of the punction. The material obtained was insufficient for evaluation on 18 occasions. The use of the method for diagnosis of rejection obtained a sensitivity and specificity of 73% and 81% respectively. Furthermore, in the group of patients with stable renal function, higher immunoactivation indexes were observed in those treated with cyclosporin in monotherapy (1.7 +/- 1.7) with respect to those who received triple treatment (0.5 +/- 0.4).

The use of fine needle aspiration cytology is safe and clinically useful in the monitoring of the post renal transplantation period. The results should be interpreted in terms of different immunosuppressive lines.