serum beta-2-microglobulin level: a parameter for early diagnosis of renal allograft rejection

for monitoring of renal transplant function, serum b2m was evaluated in 23 recipients. according to clinical diagnosis the patients were in four groups: 1) successful renal transplant the mean concentration of sb2m pretransplantation was 73.1±26.1 mg/l but decreased to nearly normal level (4.43±1.17 mg/l) within 24-48h and then reached to 3.1 mg/l duting 20 days after transplantation. 2) renal dysfunction (except rejection) the maximum changes of sb2m was 1.1 mg/l/day and no significant changes of sb2m were found between this group and group 1. 3) accelerated and acute rejection during immunological rejection crisis, sb2m level increased and after response to antirejection therapy decreased. the daily changes of sb2m allowed to diffrentiate renal dysfunction fom rejection in 84% of cases. moreover according to sb2m fluctuation levels, sb2m had a prognostic pattern for acute rejection due to significant differences between the level of sb2m on the day of clinical diagnosis of rejection and 4 days previously (p<0.025), and also 2 days before rejection (p<0.025), while this pattern was not found for serum creatinin and bun.