[Future perspectives of kidney transplant: towards a specific immunosuppression?]

The current status of immunosuppression in renal transplants is reviewed: non-specific (corticosteroids and cytostatics), lymphocyte-specific (polyclonal antilymphocyte globulin), T-specific (cyclosporine, antithymocyte polyclonal gamma globulin) with special attention to the OKT3 and monoclonal antibodies. Supported by the current experience of the use of PAN-T (OKT3) antiidiotypic monoclonal antibodies in the graft rejection treatment, a hypothesis is elaborated--feasible to demonstrate--to determine what would happen if anti-clonotypic monoclonal antibodies (the idiotypes of T lymphocytes) are used when looking for a specific immunosuppression. We conclude that the immunosuppression with anti-idiotypes, if it is confirmed, would be almost ideal.