title: Lymphocyte monitoring as a predictor of renal allograft rejection.
abstract: The ability to predict acute renal allograft rejection episodes or infectious potentials by immunologic monitoring was studied in 15 renal transplant recipients. Specifically, total circulating erythrocyte- (E) and erythrocyte-antibody-complement (EAC) rosetting cells were serially studied for the first two months after transplantation and related to immunosuppressive therapy and rejection activity. Total circulating, E-rosetting cells (T cells) were noted to be significantly depressed if rabbit anti-human thymocyte globulin (RAHTG) was used in the immunosuppression protocol. The rate at which these T cells repopulated the circulation was measured by calculating their slope (delta total E-rosettes/delta time). Patients with acute rejection had an average slope of 3.2 +/- 0.68 compared to those without rejection, whose slope was 0.74 +/- 0.35 (p less than 0.01). The rapid repopulation of T cells occurred about 10 days before clinical parameters of rejection were evident. The incidence of infection was greater in those patients with total E-rosettes less than 200/mm3. Serial monitoring of total E-rosetting cells after transplantation provides a diagnostic tool for predicting ensuing rejections and can also be used to gain information concerning the susceptibility to infection.
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007116:Immunization, Passive; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011379:Prognosis; D012397:Rosette Formation; D013601:T-Lymphocytes / Q000276:immunology*