Alloreactive T lymphocytes are the primary mediators of cellular rejection, and considerable research effort has emphasized use of mixed leukocyte culture as an in vitro system to determine T-cell alloreactivity between donor and recipient. The mixed leukocyte culture assays measure proliferative responses of alloactivated lymphocytes and offer opportunities to test for cell-mediated cytotoxicity and cytokine production, as well as quantitation and functional characterization of primed T cells. Mixed leukocytes culture procedures are technically demanding, time consuming, and difficult to interpret, and thus are not routinely used for prospective histocompatibility testing in a clinical service laboratory.
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