33647 - CXCL9 & CXCL10 (urine)
Quantitative measurement of urinary CXCL9 and CXCL10, normalized to urine creatinine, provides noninvasive biomarkers of kidney allograft inflammation. Elevated levels have been associated with acute rejection, antibody-mediated rejection, BK virus-associated inflammation, and other inflammatory causes of allograft injury. Results may support assessment of allograft immune activity but are not specific for a particular cause of injury.
About Test
CXCL9 (MIG) and CXCL10 (IP-10) are inflammatory chemokines. The combined urine assay measures both biomarkers from a single urine specimen. The treating physician should interpret the assay results with clinical findings, patient history, other laboratory data, donor-specific antibody testing, imaging, and, when appropriate, kidney biopsy findings.
ProcedureThe CXCL9/CXCL10 Screening Assay is performed on human urine specimens collected according to established specimen handling procedures. Following sample receipt and processing, aliquots are analyzed using a validated quantitative immunoassay methodology to determine the concentration of CXCL9 and CXCL10. The assay generates numerical concentrations for each analyte, which are compared with established reference ranges and clinical decision thresholds. Elevated concentrations indicate increased inflammatory activity within the renal allograft and may warrant further clinical evaluation. Testing performed at Eurofins Transplant Genomics, 18000 W 99th St, Suite#100, Lenexa, KS, 66219. CLIA #26D-2222139, Laboratory Director: Steve Kleiboeker, PhD HCLD/TS/CC )ABB)
SpecificityThe analytical specificity of the CXCL9/CXCL10 Screening Assay is evaluated through interference studies designed to demonstrate accurate quantification of CXCL9 and CXCL10 in the presence of endogenous and exogenous substances commonly encountered in urine specimens. Inclusivity is demonstrated by the assay’s ability to reliably detect target CXCL9 and CXCL10 proteins across their expected concentration ranges in human urine from diverse patient populations. Exclusivity is demonstrated by the assay’s ability to selectively measure the intended analytes without significant cross-reactivity from structurally related cytokines, urinary matrix components, medications, hemoglobin, bilirubin, lipids, or other potential interferents according to the literature. Clinically, elevated CXCL9 and CXCL10 concentrations reflect inflammatory activity and may be observed in several transplant-related conditions, including acute rejection, antibody-mediated rejection, BK virus-associated nephropathy, and other immune-mediated injuries. Therefore, assay results should be interpreted in conjunction with clinical findings, laboratory results, and other diagnostic assessments to ensure appropriate differentiation among causes of allograft inflammation.
3-4 days from receipt of specimen.
| Specimen Type | Test Code | CPT Code | NY Approved | Volume | Assay Range | Special Instructions |
|---|---|---|---|---|---|---|
| urine | 33647 | 86849 | No | Minimum 5 mL (fill to the 5 mL line) |
CXCL9/Cr ratio - 19.9 - 30,400 pg/mL CXCL10/Cr ratio - 0.60 - 920 pg/mL |
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Ambient specimens are listed as a cause for rejection. Complete urine-specific rejection criteria require laboratory confirmation.
Specimens are approved for testing in New York only when indicated in the Specimen Information field above. The CPT codes provided are based on Eurofins Viracor’s interpretation of the American Medical Association's Current Procedural Terminology (CPT) codes and are provided for informational purposes only. CPT coding is the sole responsibility of the billing party. Questions regarding coding should be addressed to your local Medicare carrier. Eurofins Viracor assumes no responsibility for billing errors due to reliance on the CPT codes illustrated in this material.
References- Singla A, Park S, Pedamallu H, et al. Diagnostic performance and resource utilization of combining blood gene expression, cell-free DNA, and urine chemokines for monitoring kidney rejection. Clin J Am Soc Nephrol. Published online May 21, 2026. doi:10.2215/CJN.0000001075.
- Hallak P, Amaral S. Sequential biomarker testing in kidney transplant surveillance: How far does one step at a time take us? Clin J Am Soc Nephrol. 2026:1-3. doi:10.2215/CJN.0000001151