Effective monitoring and modulation of immune reactivity in allograft recipients.

This study demonstrates that current techniques of immune monitoring and modulation are available, which have potential to reduce early cadaver allograft loss from rejection to 5% or less. The techniques center on the monitoring of T lymphocyte levels and T lymphocyte reactivity, using relatively simple and reproducible assays, which give results within 4-72 hrs, depending upon the tests used. In addition, these techniques include modulation of T cell levels and reactivity using quality-controlled anti-thymocyte globulin (ATG) in low doses during the post-transplant period. High potency ATG demonstrates a significant capability of preventing early (3 mos) graft rejection, as well as maintaining low levels and reactivity of T cells for 3 mos or longer, when intermittent low dose therapy is utilized. Evidence is presented that ATG has a relatively selective effect on T lymphocytes and this may result in a degree of selective immunosuppression not achieved in clinical transplantation to date.