Immune monitoring after kidney transplantation

During the last decennium, research in the field of organ transplantation changed from studying mechanisms of acute rejection shortly after transplantation to understanding why patients benefit from their grafts only for a limited time, because of irreversible chronic rejection and serious side effects of immunosuppression. To avoid side effects, tapering or even withdrawal of immunosuppression in transplant recipients is warranted, provided this is not accompanied with graft loss. Noninvasive cell mediated immune tests could be helpful to identify transplant recipients in whom the immunosuppressive load can be safely reduced, and to identify patients at risk for chronic rejection. In the present report, we describe cellular assays to determine donor-specific responses in peripheral blood mononuclear cells from transplant recipients taken before transplantation and during tapering or withdrawal of immunosuppression.