Immunologic analysis of cellular infiltrates during human renal allograft dysfunction

This study describes the results of 95 consecutive percutaneous renal allograft biopsies, using monoclonal antibodies and immunoperoxidase techniques to identify the mononuclear T cell populations associated with such graft dysfunction. The results highlight the extreme usefulness of such studies in characterizing the spectrum of intragraft immune events associated with renal injury. The present study demonstrates a marked increase in Leu 2 (cytotoxic/suppressor) T cells, with less helper T cells within rejecting renal grafts, in confirmation of other recent studies. Also demonstrated in this study is the rise in monocyte/macrophage cell populations during acute interstitial allograft rejection. Taken together, the data suggest that acute renal allograft rejection is associated with the influx of a wide variety of mononuclear cells. The majority of these lymphocytes are cytotoxic/suppressor T cells, in concordance with the isolation and functional characterization of cytotoxic T cells within such grafts.