ArticleBuckingham JM, Ritts RE, Woods JE, Ilstrup DM.
Mayo Clin Proc. 1977 Feb;52(2):101-5.
A detailed multifactorial computer analysis of several in vitro tests of cell-mediated immunity has been carried out before and after surgery in 15 renal transplant recipients. Factors studied include lymphocyte blastogenesis, T- and B-cell levels, and lymphocyte protein synthesis. Large doses of immunosuppressive agents chnage lymphocyte subpopulations. This is seen especially in transplant patients who have rejection and who have decreased numbers of circulating lymphocytes. The T cells are selectively depressed more than the B cells. This is also reflected in the greater responsiveness of pokeweed mitogen-stimulated lymphocytes compared with lymphocyte responsiveness to phytohemagglutinin and concanavalin A. In this environment, rejection takes place. These observations suggest that rejection may be initiated by cortisone-resistant lymphocytes of the thymic medullary type. Measurements of changes in lymphocyte responsiveness to mitogens or changes in lymphocyte subpopulations do not reliably predict rejection. However, measurement of lymphocyte protein synthesis fills the criterion of providing a reliable test that can be carried out quickly, and in the future may be valuable in predicting rejection.