Endogenous cell-mediated immunity, blood transfusion, and outcome of renal transplantation

The cell-mediated immunity (CMI) of a group of patients on regular dialysis was measured by a quantitative dinitrochlorobenzene (DNCB) skin test, the reaction being graded 0--15. The score in these patients varied widely, although the mean was much lower than that occurring in a group of 15 healthy subjects. 55 cadaveric renal allografts were subsequently done in 51 of these patients, and graft survival was assessed at 6 months. The 39 patients with weak DNCB skin reactions had a much higher graft survival (71%) than did the 12 with strong reaction (15%) (p less than 0.01). The weak DNCB reactors also had more pre-transplant blood transfusions. The findings suggest that the CMI of the recipient as measured by the DNCB test has an important influence on subsequent graft survival. This influence may partly be related to pre-transplant blood transfusion.