title: In vitro T cell proliferation from kidney allograft biopsies with unremarkable pathology: new strategies for an old problem.
abstract: Acute rejection of renal allografts is mediated by infiltrating alloreactive T cells. The goals of this study were to correlate T cell proliferation with rejection and to determine whether T cell proliferation in the absence of rejection would predict future rejection episodes. Toward this, kidney biopsies (n=100) were cultured in the presence of interleukin-2. Cultures were examined at 4, 24, and 48 hr for T cell proliferation. A strong correlation was observed between T cell proliferation at any time point and rejection. There was not a significant correlation between T cell proliferation in biopsies with no rejection and the occurrence of a rejection episode within 2 months. However, T cell proliferation after 4 hr was a better predictor of the occurrence of rejection within 2 months compared with observations after 24 and 48 hr. Therefore, a subgroup of patients with unremarkable biopsies but T cell proliferation may be at risk for rejection and warrant closer observation and possible tailoring of immunosuppression.
authors.affiliation: Department of Surgery, Washington University School of Medicine, Box 8109-3328.CSRB, 660 South Euclid Avenue, St. Louis, MO 63110-1093, USA.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Andrés
authors.initials: A
authors.lastname: Jaramillo
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Poindexter
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Steward
authors.forename: Kim C
authors.initials: KC
authors.lastname: Lu
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
authors.forename: Gary G
authors.initials: GG
authors.lastname: Singer
authors.forename: Brent W
authors.initials: BW
authors.lastname: Miller
authors.forename: Martin D
authors.initials: MD
authors.lastname: Jendrisak
authors.forename: Surendra
authors.initials: S
authors.lastname: Shenoy
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lowell
authors.forename: Todd K
authors.initials: TK
authors.lastname: Howard
authors.forename: T
authors.initials: T
authors.lastname: Mohanakumar
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D008213:Lymphocyte Activation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous