Granulocyte function in recipients of renal transplant from live related donors and from cadavers

Granulocyte adherence, chemotaxis, phagocytosis, and bactericidal activity were studied in patients receiving renal transplants to determine whether defects in granulocyte function can explain increased susceptibility to infection. Five points were studied: preoperatively; immediately after transplantation; at the time of any rejection crises (when the patient was receiving large doses of prednisone and azathioprine); at discharge; and six months postoperatively with stable renal function. The major defect was depressed granulocyte adherence early postoperatively and at the time of rejection crises, when prednisone dosage was maximal. Chemotactic activity improved progressively after transplantation despite large doses of prednisone and azathioprine and was supranormal at the time of rejection crises. Phagocytosis was enhanced early postoperatively and at the time of rejection crises. Bactericidal activity was unaffected by renal transplantation and immunosuppressive therapy in recipients of transplants from live related donors, but was depressed in recipients of cadaveric kidneys.