Anti-N in patients undergoing regular haemodialysis: a possible association with renal transplant failure

Six patients on regular haemodialysis in the Auckland renal dialysis unit developed the antibody anti-N. All utilised formaldehyde resterilisation dialyser procedures. Four patients with anti-N underwent renal transplantation unsuccessfully. Histological changes were difficult to interpret and could not be closely correlated with serological findings, although vessel thrombi and renal tissue infarcts were seen in some kidneys. It is recommended that renal patients should be screened at 4 degrees C and room temperature for anti-N and that resterilisation of dialysers be carefully controlled. Where transplantation is to be performed in a patient with anti-N, the organ should be warmed and perfused with warm saline prior to grafting.