In vitro T cell proliferation from kidney allograft biopsies with unremarkable pathology: new strategies for an old problem.
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.
Smith
Craig R
CR
Department of Surgery, Washington University School of Medicine, Box 8109-3328.CSRB, 660 South Euclid Avenue, St. Louis, MO 63110-1093, USA.
Jaramillo
Andrés
A
Poindexter
Nancy J
NJ
Steward
Nancy S
NS
Lu
Kim C
KC
Brennan
Daniel C
DC
Singer
Gary G
GG
Miller
Brent W
BW
Jendrisak
Martin D
MD
Shenoy
Surendra
S
Lowell
Jeffrey A
JA
Howard
Todd K
TK
Mohanakumar
T
T
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