Prognostic significance of the active thymus derived rosette forming cells in renal allograft survival: a preliminary report.

The prognostic significance of hemodialysis, blood transfusions, total T (T-T) and active T (A-T) lymphocytes, as they relate to renal allograft survival, were evaluated in 36 renal transplant recipients. The A-T cell is thought to be a surveillance cell responsible for cellular immunity and the only prognostic factor for graft survival observed in this study. An 83% graft survival rate occurred in patients having a lower percentage of A-Ts (fewer surveillance cells) prior to renal transplantation, as compared to 50% graft survival in patients with a higher percentage of A-T cells. Evaluation of pretransplant T-T cells, phytohemagglutinin (PHA) response, and number of transfusions was not prognostic for graft survival. Similarly, there was no difference in graft survival rates in patients hemodialyzed for more vs less than 1 year. Patients hemodialyzed for more than a year received twice as many blood transfusions. There were no differences in the number of T-T or A-T lymphocytes in either group. However, lymphocytes from patients hemodialyzed less than a year were more responsive to PHA stimulation. These data suggest that pretransplant determination of A-T cell values may be prognostic for graft survival and may delineate patients, by an immunological parameter, who may be at high risk for allograft rejection.