Treatment and prevention of allograft loss in organ transplant recipients relies chiefly
on non–antigen-specific immunosuppression. Current approaches to the management of
these immunosuppressive drugs are largely empiric and reactive because of lack of
immune monitoring assays. Alloreactive T cells play a key role in acute rejection
and in development of chronic allograft nephropathy, the leading cause of late allograft
failure. There is thus an increasing interest in development of simple, reliable,
noninvasive assays measuring allogeneic anti-donor responsiveness or donor-specific
nonresponsiveness to predict ransplantation rejection and tolerance. Because the frequency
and cytokine profile of alloreactive T cells play an important role in these processes,
this article mainly focuses on assays that enumerate cytokine-producing alloreactive
T cells.
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