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S.V.

JAMA. 1970;212(10):1696-1697.

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Unlike the hyperacute renal allograft rejection which strikes suddenly within hours after transplantation, the acute rejection of the grafted kidney may be arrested if detected in its early premonitory stage. When clinical manifestations of rejection appear, it may be too late for effective treatment. Much effort has therefore been expended to find clues toward diagnosing rejection in its subclinical phase.

One of the oldest (1964) laboratory tests for rejection is the examination of urinary sediment for lymphocytes. Having observed mixed lymphocytes and tubular cell casts in stained urinary sediments of seven out of nine patients with impending rejection, Kauffman et al² recommended the diagnostic use of urinary sediment staining at frequent intervals after transplantation. Another urine test based on enzymatic rather than morphologic study was introduced by Noble and co-workers² who found increased urinary lysozyme activity before clinical rejection became manifest. Serologic tests based on the immune responses . . . [Full Text PDF of this Article]

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