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Summary. A spectropliotometric method was used to show that azathioprine ("Iinuran",) is converted into 6-mercaptopiirine hy a second-order reaction with glutatliione. In the pH ranne studied (6-85-8-45), at 37° in 50 niM phosphate, the rate of formation of 6-mt*rcaptopiirine is given hy the expression: d[6-merc:iptopurine]/dt " 0 32 (pH -6R) [azatlitoprine] [gKitathione] mole .sec.-* litre-'. The results were applicahle to U»e formation of 6-mercaptopurine from azathioprine and gliitathionc iu plasma. The half-time for conversion of azathioprine into 6-nu'rcaptopurine at pH 7-35 and 37° in the presence of 1 mM glutatliione was 47 min.At pH values ahove 10 formation of 5-niercapta-l-methyl-4-nitroiniidazole from azathioprine was ohser\'ed in vitro. The mercaptoimidazole was detected in the nrine of patients after oral doses of azathioprim-. A spectrophotonietric a.ssay after fractionation on Sephadex G-15 was used to follow the time-course of excretion of the iniid;r/t)l('.Net conversion of aziithioprine into 6-thiouric acid after treatment with azathioprine wa.'i followed hy a spectrophotonietric assay in\olving co-prccipitation of urinar>' 6-thiouric acid with uric acid. Tlie tiuie-cour.sc of urinary 6-thiouric acid excretion was similar to that of the mercsiptoimidazolc. and is consistent with the rates of azathioprine cleavage observed in vivo. These metabolites were mainly excreted within H hr. of an oral dose of azathioprine.The relevance of these results to the action of aziithioprim' and to improvemeuts in control of its clinical use are discussed.

The Renal Unit of the Queen Elizabeth Hospital, Adelaide, South Australia, provides the only specialized renal service for the State's population of one million. Established two years ago, it has developed a programme of recurrent haemodialysis and has used recurrent peritoneal dialysis for a period. It is associated with a renal homotransplantation programme. The Unit staff consists of a full time Director, one Senior Medical Registrar, a Senior House Physician, nurses and technicians. There is a close liaison with the University of Adelaide Department of Surgery which has been responsible for establishing and running the homotransplantation programme with a staff of a Senior Lecturer and the assistance of two Honorary Assistant Surgeons. The psychiatrist works closely with the group and interviews all patients entering the programme. His role has been that of an observer and adviser on the management of patients in chronic renal failure, and in the psychological screening of potential kidney donors.

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