New methods for assessing the status of
transplant rejection in transplant recipients, such as
kidney transplant recipients, are disclosed. The
diagnostic methods utilize the measurement of TCR
subunit repertoire diversity to identify stable subjects, subjects undergoing
cell-mediated rejection processes, and subjects undergoing
antibody-mediated rejection processes. The proportion of unique TCR alpha and beta
subunit sequences to the total unique TCR
subunit sequences (total sequences of alpha, beta,
delta, and gamma subunits) provides a diagnostic measure that can identify stable subjects, subjects undergoing
cell-mediated rejection processes, and subjects undergoing
antibody-mediated rejection processes. If
antibody-mediated rejection or
cell-mediated rejection is detected, treatment methods include administration of appropriate therapy.