Delayed hypersensitivity skin tests and subsequent renal transplant outcome

Area of Science:

• Nephrology
• Immunology
• Transplantation

Background:

• Previous studies on delayed hypersensitivity skin tests (DHST) and renal transplant outcomes yielded conflicting results.
• Many prior studies were conducted before the cyclosporine era and lacked control for confounding variables impacting graft and patient survival.

Purpose of the Study:

• To evaluate the predictive value of pretransplant DHST results on renal transplant outcomes.
• To investigate this relationship specifically within the context of the cyclosporine era.

Main Methods:

• 103 first cadaveric renal transplant recipients underwent pretransplant DHST using recall antigens.
• Patients were categorized into positive skin test (STP+) and anergic (negative skin test) groups.
• Allograft and patient survival rates were compared between groups, controlling for known influencing factors.

Main Results:

• Demographic and HLA matching characteristics were similar between the STP+ and anergic groups.
• Three-year renal allograft survival rates were 72% for the STP+ group and 57% for the anergic group (not statistically significant).
• Three-year patient survival rates were 97% for the STP+ group and 85% for the anergic group (not statistically significant).

Conclusions:

• Delayed hypersensitivity skin tests are not a reliable predictor of renal allograft or patient survival.
• DHST results do not offer significant prognostic value for transplant outcomes within a three-year period.