Immunologic Studies in Human Organ Transplantation

Twenty-eight patients with chronic renal diseases and uremia were investigated with respect to their cutaneous responsiveness to a panel of antigens expected to elicit immediate and delayed hypersensitivity reactions. Compared to a control group, there was a marked decrease in the incidence of responses of both types. Eighteen patients received renal allografts from members of the control group and were available for restudy in the postoperative period prior to the institution of adrenal steroid therapy. Each recipient acquired delayed responsiveness with specificity identical with that of the kidney donor. The donor group was reactive to 49 antigens to which the recipients were non-reactive preoperatively. Postoperatively, 40 of these reactivities were observed in the recipients. This successful demonstration of the transfer of immunologically competent tissue in association with renal transplantation indicates that the cause of depressed cutaneous hypersensitivity in uremia is not an inability of the skin per se to react.