Detecting and Treating Early Renal Homotransplant Rejection

The recipient of a renal transplant who is not genetically identical with the donor immediately falls victim of a new disease: renal homotransplant or renal-heterotransplant rejection. Since measures to induce specific immunologic tolerance to renal homotransplants are as yet unavailable, survival of the recipient is dependent upon effective therapy of his new disease.

The long-term results in both man and animals for experimental use whose survivals have depended on a single life-sustaining renal homotransplant have been poor.¹² Some died from overdosage of the immunosuppressive drugs while the transplant exhibited good function, and others of homotransplant rejection from inadequate therapy. It has been suggested that the usual parameters of renal function were inadequate for early detection and monitoring of the immunologic reaction in renal homotransplants, especially in modified recipients.^2-4 The usual dosage guide of immunosuppressive-drug therapy in renal homotransplantation has been a balance between toxicity, chiefly on the hematopoietic