THE REVERSAL OF REJECTION IN HUMAN RENAL HOMOGRAFTS WITH SUBSEQUENT DEVELOPMENT OF HOMOGRAFT TOLERANCE.

Abstract

Because of the high failure rate after renal homotransplantation, there has been an air of pessimism concerning the possibility of long term function of the grafted kidney. The immunologic processes subserving rejection are generally thought to be so powerful and persevering that consistent success cannot be expected with the use of any of the currently available methods of antirejection therapy. Recent personal experience in caring for patients with renal homografts has resulted in alterations in many of our preconceived notions concerning the management of such patients. It has led to the beliefs that the rejection process can almost never be entirely prevented, but that its effects can be reversed with a high degree of regularity and completeness. Furthermore, the subsequent behavior of patients who have been brought through a successfully treated rejection crisis suggests the early development of some degree of host-graft adaptation, since the phenomenon of vigorous secondary rejection has been encountered only once.