Immunological monitoring in organ transplantation and autoimmune disease.

The clinical manifestations of graft rejection or autoimmune disease represent the terminal phase in a complex sequence of inflammatory events. Although the spectrum of response to injury within each tissue is normally narrowly defined, the immune mechanisms involved may be heterogeneous, influenced by the immune status of the host, the nature of the stimulus (i.e. viral antigen, allostimulation, or aberrant recognition of self), and the use of exogenous immunosuppression. Within this framework, immunological monitoring is employed to distinguish the causative effector mechanisms, to characterize the disease course, to tailor therapeutic intervention, and to monitor treatment impact in individual immunological disorders.