The Use of in vitro Lymphocyte Responsiveness to Specific Mitogenic Agents in the Immunological Monitoring of Human Renal Allograft Recipients

In the course of immunologically monitoring the clinical progress of 16 renal allograft recipients, blood was drawn at serial intervals and patient in vitro lymphocyte reactivity to streptolysin-O and streptokinase-streptodornase studied. In vitro lymphocyte responsiveness to these specific mitogens provided no consistent guide to the adequacy of immunosuppression for maintenance of stable renal function. Variations in responsiveness gave no indication of either impending or actual rejection crises. Short-term culture (4 h) assessment of phyto-hemagglutinin responsiveness using the 3H-uridine method also failed to provide clinically useful information for these purposes. We conclude that conventional specific and non-specific mitogenic assays of lymphocyte functional integrity cannot be used to evaluate either the effectiveness of immunosuppressive medication or the development of rejection episodes.