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T‐Cell Clonal Change after Allo‐Kidney Transplantation in Humans

Whether T cells circulating peripherally express changes at a clonal level after renal transplantation is uncertain. To clarify this issue, we analyzed T‐cell clonality of peripheral blood lymphocytes (PBLs) in 12 renal transplant recipients by a novel polymerase chain reaction–single‐strand conformation polymorphism (PCR–SSCP) method that can discriminate T‐cell clones with different T‐cell receptor (TCR) Vβ motifs. The PCR–SSCP study showed that after transplantation, only a few distinct T‐cell clonotypes accumulated in the absence of clinical episodes, irrespective of the compatibility of HLA antigens. In contrast, various T‐cell clones appeared in cases of acute rejection (AR) and infection. These subsided immediately after the AR was resolved; however, they remained long after the resolution of the infection. In a case of AR followed by an infectious episode, distinct T‐cell clones appeared concomitantly with each episode. Several of them disappeared or remained thereafter. In one case, significant numbers of accumulating bands were observed by in‐vitro stimulation by mixed lymphocyte reaction (MLR); several were identical to those found in vivo. However, some of those that did not appear in vitro were apparent in vivo. In conclusion, the appearance of T‐cell clonotypes at a peripheral level indicates the existence of immunologically activated T‐cell clones, which were significantly affected by immunosuppressive therapy. It was also determined that the T‐cell immune system is much more complicated in vivo than in vitro.