The value of monitoring T-lymphocyte subpopulations after kidney transplantation

Availability of monoclonal antibodies against lymphocyte subpopulations facilitates serial monitoring of such cells after kidney transplantation. This report describes serial monitoring of such cell levels in 25 patients before and after transplantation, using OKT3, 4, 8 (Ortho) antibodies. All patients were treated by standard immunosuppression (Imuan and Prednisone). Similar determinations were done in normal subjects and in patients on hemodialysis awaiting transplantation. There were no differences in levels of total T-cells (OKT3), helper/inducer cells (OKT4) or suppressor/cytotoxic cells (OKT8) in the latter two populations. After transplantation, however, there were sharp declines in OKT3 and OKT4 levels, with some reductions in OKT8 levels, so that relative decreases in OKT4/OKT8 ratios (0.99 versus 1.90), which persisted for 3 months, occurred uniformly in the recipients. Further change in OKT4/OKT8 ratios were of help in the diagnosis of allograft rejection in only 1 rejection crisis. The results indicate marked reductions in T-cell levels immediately after transplantation, possibly related to early intensive steroid therapy, with gradual return to baseline levels after 3 months. Neither T-cell levels nor OKT4/OKT8 ratio changes appear to be of usefulness in the diagnosis of rejection crises.