AIM to assess the role of immunological mechanisms in the development and progression of chronic transplant nephropathy (CTN) and the prognostic value of rapid computer morphometry of lymphocytes in predicting the risk of renal allograft rejection. SUBJECTS AND METHODS Thirty-seven renal graft recipients (29 males and 8 females; mean age 35.9 +/- 2.2 years; mean time after renal allografting 19.9 +/- 2.7 months). Twenty-three patients had satisfactory renal graft function; 14 patients were diagnosed as having CTN. A control group included 30 apparently healthy individuals. Along with physical examination, vital computer phase morphometry (CPM) of peripheral blood immunocompetent cells was carried out in all the patients. RESULTS Small and average cells were predominant in the T and B lymphocyte populations. In CTN, there were increases in diameter, perimeter, and area and decreases in the phase height and volume of B lymphocytes, which is indicative of their activation. There was a predominance of average B lymphocytes in CTN. CONCLUSION Vital CPM of peripheral blood immunocompetent cells may be used for the early diagnosis and prediction of CTN development.

The article focuses on the results of the investigation of peripheral blood lymphocyte morphofunctional status in healthy volunteers and renal allograft recipients for early postoperative period. Working out noninvasive tests for diagnosis of acute renal allograft rejection based on the measuring of cell morphometric parameters by method of coherent phase microscopy (CPM). It was found out that the lymphocyte phase height was proportional cell image density and its geometrical thickness. Our results showed that the variations of immunocompetent cell morphometric indicants can be in advance the dynamics of blood creatine increasing and answer for early criteria of acute renal allograft rejection.

Results of clinical application of acute vital computer morphometry to diagnose acute rejection of renal allograft are presented. Patients with the end stage renal disease were observed in dynamics of the early post-operative period including recipients with satisfactory and stable function of renal allograft and those with acute allograft rejection confirmed by clinical and laboratory data. Criteria for the early diagnosis of allograft rejection were proposed on the basis of the morphofunctional condition monitoring of living lymphocytes of the peripheral blood.

The morphofunctional status of peripheral blood platelets from 16 recipients, 16 optimal and 16 marginal donors renal allograft were investigated by method of vital computer phase morphometry (phase-interference microscope "Cytoscan"). The abnormality of platelet hemostasis was found out in recipients and potential renal allograft donors. Such hemostasis damages can promote the thrombotic complications and failure of microcirculation in renal parenchymatous tissue.