[The alternation of CD4+ cells and its subpopulations by serial monitoring of peripheral blood lymphocytes of renal allograft recipients].
Immunologic monitoring for renal allograft recipients should be carried out serially and as conveniently as possible so that we can catch and treat the initial alternation of the rejection and infection. We have introduced the serial analysis of lymphocyte surface antigens of peripheral blood lymphocytes by flow cytometry for 9 cases of renal allograft recipients (3 cases of living related, 2 cases of living non-related, and 4 cases cadaver donors). In three recipients without rejection and infection, T4+(CD4+), T4+4B4+(CDw29+), T4+2H4+(CD45R+), T4+I2+(HLA-DR+), and T4+IL-2R+(CD25+) subsets showed variable processes for first 10 days and then stable processes. On primary rejection of 5 cases, activated T cell subsets such as T4+I2+ and T4+IL-2R+ subsets showed peak formations within 2 days before the rejection. Two of these 5 cases resisted a primary rejection therapy and showed a rebounding rise of these subsets. We could easily convert to OKT-3 rescue therapy and treat them successfully. We could not find out the specific alternation in the secondary rejection of 2 cases and all the infection cases. On the basis of these findings, we should serially monitor the T4+I2+ and T4+IL-2R+ subsets daily for first 2 weeks and after then 3 times a week, in order to catch the initial alternation of the primary rejection and treat its rebound successfully.
Mori
Y
Y
Department of Surgery, Saga Prefectural Hospital.
Shiramizu
T
T
Yayama
T
T
Oka
N
N
D000328:Adult; D015704:CD4 Antigens / Q000032:analysis*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D013601:T-Lymphocytes / Q000276:immunology*
D015704:CD4 Antigens