Rapid correction of red-cell nucleotide abnormalities following successful renal transplantation

Erythrocyte levels of 5' mono-, di- and triphosphates of adenosine, inosine and guanosine, together with NAD+ (H) and NADP+ (H) were measured before and serially after renal transplantation. The high levels of ATP and guanosine triphosphate (GTP) fell to normal within 3 d of achieving a normal plasma creatinine. The decline in ATP and GTP levels paralleled the fall in plasma creatinine. Acute graft rejection was accompanied by a rise in ATP and GTP, both of which returned rapidly to normal with resolution of the rejection episode. Radiolabelling of red cells confirmed that the metabolism of the existing red-cell population was corrected so that observed changes in nucleotide concentrations were not due to a new cohort of cells.