Background: The presence of anti-HLA antibodies, especially the presence of donor specific antibodies was associated with graft rejection after transplantation. The aim of our work was to analyze whether there is a correlation between actual-crossmatch performed by Luminex and virtual-crossmatch assessed on the basis of recipient’s anti-HLA antibody specificities.

Material and Methods: Anti-HLA antibodies screening ± identification and crossmatch tests were performed before renal transplantation in 310 potential recipients, using Luminex technology. For all patients and donors, pretransplant HLA genotyping for A, B, and DRB1 loci were performed using molecular biology methods. To perform virtual crossmatch, the recipient’s HLA-antibody specificities were compared against the donor HLA alleles.

Results: The anti-HLA antibodies screening was positive in 65 recipients (103 positive results): 15 patients (23%) presented anti-HLA class I antibodies, 12 patients (18.5%) had anti-HLA class II antibodies and in 38 subjects (58.5%) we discovered both types of antibodies. Using LSA assay, we could determine the antibody specificities only in 87 cases. Comparing the recipient’s anti-HLA antibody specificities with donor’s HLA antigens we found positive virtual-crossmatch in 81 cases. For 620 crossmatch results, the sensitivity, specificity, positive and negative predictive values were 87.6%, 97.8%, 85.5% and 98.1%, respectively.

Conclusion: virtual-crossmatch assessed on the basis of recipient’s anti-HLA antibody specificities had a good correlation with actual-crossmatch performed by Luminex and thus, had a high sensitivity in predicting donor-recipient immunologic compatibility. Using the virtual crossmatch may improve graft allocation strategy for kidney recipients reducing the waiting time on the waiting list.

Objectives: Although less than 3% of patients with Catheter Associated Asymptomatic Bacteria (CA-ASB) develop bacterimia with urinary pathogen; risk is 36 times increased with indwelling catheter. This study aimed at evaluating the uropathogens and the antimicrobial susceptibility in men with bladder outlet obstruction due to BPH to create baseline data for active surveillance and empiric antimicrobial regimens.

Methods: Urine cultures from 78 men with urinary retention secondary to BPH were evaluated. Distribution of the bacteria causing catheter associated bacterimia and their antimicrobial susceptibility test results were examined using automated identification and antimicrobial susceptibility testing system.

Results: A large proportion of patients with CA-ASB were older (≥60 years; P=0.02). The prevalence of infection was significantly higher in patients on urethral catheters than those on suprapubic catheters. (P=0.011) There was a high prevalence of micro-haematuria and proteinuria (60.5% and 37.2% respectively). Escherichia coli was the commonest organism found in all age groups. There was increased resistance of organism to the four commonly used urinary tract antibiotics (ampicillin, perfloxacin, levofloxacin and erythromycin). The prevalence of multi-resistance was 10.8%.

Conclusion: In a total of 78 samples, 83.3% showed significant growth of pathogens. A slightly more cases of CA-ASB were recorded among elderly patients (≥65 years; 52.3 %). Nitrofurantoin is recommended as the first drug of choice in this country if not contraindicated.

Urinary Tract Infection (UTI) has been one of the pivotal agents of morbidity in the Intensive Care Unit (ICU) worldwide. UTI’s in the ICU cause significant mortality and increase the length of ICU stay, thereby increasing the bane on healthcare costs worldwide. We aim to review literature and elaborate on the several factors leading to the causation of UTI’s in the ICU.

The standard surgical treatment of distal ureteric transitional cell carcinoma remains nephroureterectomy with excision of a cuff of bladder. We present a series of 20 patients who were managed with open distal ureterectomy and Boari flap reconstruction.

Objective: To study the suitability of open distal ureterectomy and Boari flap reconstruction in the management of distal ureteric TCC.

Methods: Data was collected retrospectively on one consultant’s patients, operated on between 2004-2015.

Results: We treated 20 patients with a mean age of 71 years (55-88 years). There were thirteen males and seven females. Six tumours were on the right and fourteen on the left. The mean follow up was 79 months (6.5 years) (8-144 months) with three recurrences (2 ureteric, 1 renal pelvis). There has been only one complication.

Conclusion: Upper urinary tract tumours are rare. Radical nephroureterectomy with excision of bladder cuff may over treat this disease compromising renal function unnecessarily. In selected cases open distal ureterectomy and Boari flap reconstruction may be considered.

Inflammatory myofibroblastic tumor is an rare soft tissue tumor which characterized by proliferation of myofibroblastic spindle cells and inflammatory cells. Inflammatory myofibroblastic tumor of the bladder and other spindle cell neoplasms of the bladder can exhibit similar clinical features. It is important to differentiate this tumor from the other spindle cell neoplasms. At this point, immunochemistry has a significant role. Anaplastic lymphoma kinase-1 has been considered diagnostically effective. Herein, we describe a case of 15-year-old boy with an inflammatory myofibroblastic tumor of the bladder. Fluorescence in situ hybridization analysis and immunohistochemical markers helped in correct diagnosis and further treatment decision.