MP37-15 DETECTION OF DECOY CELLS IN SIX MONTHS OR MORE ON URINARY CYTOLOGY EFFICIENTLY AND COST-EFFECTIVELY PREDICTS BK VIRUS NEPHROPATHY IN RENAL TRANSPLANT RECIPIENTS

Abstract

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-15 DETECTION OF DECOY CELLS IN SIX MONTHS OR MORE ON URINARY CYTOLOGY EFFICIENTLY AND COST-EFFECTIVELY PREDICTS BK VIRUS NEPHROPATHY IN RENAL TRANSPLANT RECIPIENTS Takanori Sekito, Motoo Araki, Kasumi Yoshinaga, Syogo Watari, Yuki Maruyama, Takuya Sadahira, Shingo Nishimura, Koichiro Wada, Tomoko Sako, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Hiroyuki Yanai, and Yasutomo Nasu Takanori SekitoTakanori Sekito More articles by this author , Motoo ArakiMotoo Araki More articles by this author , Kasumi YoshinagaKasumi Yoshinaga More articles by this author , Syogo WatariSyogo Watari More articles by this author , Yuki MaruyamaYuki Maruyama More articles by this author , Takuya SadahiraTakuya Sadahira More articles by this author , Shingo NishimuraShingo Nishimura More articles by this author , Koichiro WadaKoichiro Wada More articles by this author , Tomoko SakoTomoko Sako More articles by this author , Kohei EdamuraKohei Edamura More articles by this author , Yasuyuki KobayashiYasuyuki Kobayashi More articles by this author , Masami WatanabeMasami Watanabe More articles by this author , Toyohiko WatanabeToyohiko Watanabe More articles by this author , Hiroyuki YanaiHiroyuki Yanai More articles by this author , and Yasutomo NasuYasutomo Nasu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: BK virus nephropathy (BKVN) is one of the important causes of graft loss after kidney transplantation (KT). This study analyzed the association between the duration of positive decoy cells in urine cytology and BKVN. METHODS: Totally, 121 kidney transplant recipients were retrospectively evaluated. Urine cytology was routinely monitored every month during first 6 months after KT, every 1 to 2 months during second 6 months, every 1 to 3 months afterward. The best duration of consecutive presence of decoy cells to predict BKVN was analyzed by calculating the area under the curve (AUC) among each duration, and recipients were divided into two groups based on the best predictive performance. The effectiveness of SV40 immunostaining on urinary cytology was also analyzed. RESULTS: In total, 2,534 urine specimens, and 2,241 SV40 immunostaining for urine specimens were analyzed. The six consecutive months of decoy cells had best predictive performance in BKVN (AUC = 0.819). Recipients were divided into two groups based on the six or more consecutive months of decoy cells (decoy ≥ 6M, n=47) or less than six months (decoy < 6M, n=74). The incidence of BKVN in decoy ≥ 6M had significantly higher than those in decoy < 6M (5 vs 0, p = 0.008). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to predict BKVN by detecting decoy cells was 100%, 64%, 11% and 100% respectively. SV40 immunostaining provided slightly better specificity (68%) and PPV (12%) with equivalent sensitivity (100%) and NPV (100%) (Table 1). The monthly screening by decoy cells can annually save U.S. $256,520 in 121 patients (U.S. $2,120 per patient) compared to the monthly screening by plasma quantitative PCR, and U.S. $55,660 in 121 patients (U.S. $460 per patient) compared to the monthly screening by urinary SV40 immunostaining. CONCLUSIONS: The detection of decoy cells in six months or more on urine cytology can predict BKVN efficiently and cost-effectively in KT recipients. SV40 immunostaining on urine cytology adds minimal effectiveness. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e652-e652 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takanori Sekito More articles by this author Motoo Araki More articles by this author Kasumi Yoshinaga More articles by this author Syogo Watari More articles by this author Yuki Maruyama More articles by this author Takuya Sadahira More articles by this author Shingo Nishimura More articles by this author Koichiro Wada More articles by this author Tomoko Sako More articles by this author Kohei Edamura More articles by this author Yasuyuki Kobayashi More articles by this author Masami Watanabe More articles by this author Toyohiko Watanabe More articles by this author Hiroyuki Yanai More articles by this author Yasutomo Nasu More articles by this author Expand All Advertisement Loading ...