Defective Immune and Phagocytic Functions in Uraemia and Renal Transplantation

Abstract

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 in both groups. Infectious complications were often associated with defective cellular immunity, but fatal infections occurred only in transplant patients 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.

Effects of Different Forms of Dialytic Treatment on Serum Antibacterial Activity in Patients with Chronic Renal Failure

“…Many studies have been published on antibacterial properties of uremic sera, with variable results [4,13,14,16]. These results are not comparable with pre vious investigations [12] and the present study, because we tested the antibacterial activity of uremic sera in the absence of granulocytes, whereas other workers evaluated the bac tericidal capacity of granulocytes in the presence of uremic sera [4,14,15].…”

Immune Abnormalities in Renal Failure and Hemodialysis

“…Variable results of in vitro lympho cyte blastogenesis in uremic patients have been found. Several investigators found that lymphocytes suspended in normal human or fetal calf serum had decreased proliferative response to phytohemagglutinin, concanavalin A, or tuberculin purified protein [18,22,53,54] while others have reported a normal or increased lymphocyte response [11,20,37], One consistent finding is that uremic serum or plasma is inhibitory for normal or uremic lymphocyte responses to mitogens [18, 20, 38. 54, 55], When lymphocytes from uremic patients are washed and resuspended in normal se rum, the suppression is reversed [55,56].…”

Analysis of Polymorphonuclear Leukocyte Respiratory Burst Activity in Uremic Patients using Whole-Blood Chemiluminescence

“…PMNL bactericidal capacity has been reported to be decreased [3] or normal [4,5], while phagocytosis per se has been reported to be depressed [6][7][8][9], unchanged [3][4][5] or even slightly increased [10], Respiratory burst activity has been assessed by two different methods with equally conflict ing results. Protein iodination has been reported to be decreased [11] or unchanged [4,12], and reduction of the dye nitroblue tetrazolium by latex-stimulated PMNL has also been reported to be diminished [5] or normal [10],…”