Neutrophilic Tubulitis as a Marker for Urinary Tract Infection in Renal Allograft Biopsies With C4d Deposition

摘要: Background. Neutrophilic tubulitis accompanied by intratubular neutrophil clusters in the renal allograft is a surrogate marker for urinary tract infection (UTI). Overlapping histologic findings can occur antibody-mediated rejection, which characterized peritubular capillary (PTC) deposition of C4d. This study evaluated incidence UTI biopsies with concurrent neutrophilic and PTC C4d staining. Methods. Thirty-three from 27 patients selected presence simultaneous staining were correlated urine culture (U/C) results. Results. U/C obtained on same day as biopsy confirmed 13 33 (39%) biopsies. Among 20 negative U/C; prior results within 10 days available nine patients, 5 9 (55%) positive. Thus, was 18 (54%) Biopsy interpretation clinical management confounded changes acute cellular rejection demonstration donor-specific antibodies. Combined therapy antibiotics antirejection medications (ART) administered to 12 (67%) patients. Conclusions. tubular lumen useful UTI, even deposition. Therapeutic response limited co-existent T-cell or underlying chronic nephropathy.