Abstract
A simple, rapid, and specific immuno-logical test has detected the onset and progression of the immune responses of patients to their renal allografts. Within 5 hours of their application, immune (but not non-immune) peripheral leucocytes aggregated around donor-type kidney or skin fibroblast cells which had been maintained as monolayers in tissue culture. The pattern of reactivity in twenty-three patients revealed immunological specificity for antigens present in the kidney donor. Leucocyte aggregation in vitro was detected several days before clinical evidence of rejection. After reversal of rejection, host peripheral leucocytes were unresponsive in vitro. On the other hand, if the rejection could not be reversed and the transplanted kidney was removed, the patient's leucocytes displayed specific cellular reactivity for months. These observations suggest that an in-vitro test may be used in the routine evaluation of graft recipients to detect pre-existent sensitisation and to obtain an early diagnosis of renal allograft rejection.
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