Defective immune and phagocytic functions in uraemia and renal transplantation

The humoral, cellular and neutrophil responses of uraemic patients maintained by haemodialysis were compared with those of renal transplant recipients. Humoral immunity was reduced only in the transplant group. Cell-mediated immunity was abnormal in both groups but more decreased in the transplant group studied particularly within 3 months of transplantation. The neutrophil bactericidal capacities were defective cellular immunity, but fatal infections occurred only in transplant patterns over 40 years of age with combined cellular and neutrophil defects. No single test was predictive of graft survival in uraemic patients. The depressed cellular immune responses in uraemia, of the degree seen in the immunosuppressed transplant recipient, may explain the better prognosis of renal transplants compared with other organ transplants.