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We examined 960 urine specimens from 12 renal transplant patients for the presence of thymus-derived rosette-forming cells as a post-transplant study. Active T-rosette-forming cells appeared in the urine before or simultaneously with an increase in serum creatinine during all 14 acute rejection crises. Moreover, the active urinary T-rosette-forming cells disappeared promptly after pulse treatment with large doses of methylprednisolone in 11 rejection crises, which resolved completely, while in patients with continued detection of active T-rosette-forming cells in the urine rejection crises recurred within a few weeks. It is suggested that the test for active urinary T-rosette-forming cells is a simple and reliable method to diagnose acute renal allograft rejection.
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