Immunology of renal transplantation rejection

Recent studies into the mechanisms of graft rejection have highlighted the complexity of this response. Although current immunosuppressive treatments are crude, laboratory observations on the mechanisms of graft rejection have already led to various techniques which may assist in the early diagnosis of rejection, in the prognosis of a rejection episode, and in the development of more specific therapy to prevent and treat rejection. Already, the monitoring of T-cell subsets in blood and graft infiltrates is of considerable help. These observations may lead to the advent of more specific and subtle immunosuppressive therapy, such as the use of monoclonal antibodies directed against T-cell subsets. In the long term, the induction of states of specific unresponsiveness to the graft holds great promise, as do the development of techniques to assess adequacy of immunosuppression and to detect the presence of specific unresponsiveness.