Development of anergy to XXXX antigens following renal allotransplantation.

@entity1 @entity295 @entity5 @entity5507 @entity56 @entity204
A study is reported of @entity1 receiving 180 renal allotransplants and at risk for 1 or more years who had pretransplant and posttransplant skin tests using @entity56 ( @entity56 ) recall antigens. Pretransplant skin testing revealed an incidence of 14% anergic @entity1 prior to a first transplant, and 35% were anergic prior to a second allograft. There was a statistically significant correlation between pretransplant anergy and age, as well as a significant correlation between pretransplant anergy and time of dialysis-dependent @entity5507 . The conversion to the anegic state posttransplant in those @entity1 with surviving allografts increased annually for the first 5 years as a linear function, with 69% of the population at risk with their first transplant exhibiting anergy by 5 years. In those @entity1 receiving second renal transplants, all were anergic by 4 years posttransplant. In vitro tests of lymphocyte function using mitogen stimulation did not reveal significant differences between anergic and responsive @entity1 . In this series of 180 allografts there were 14 late deaths. Eleven of these were in anergic @entity1 and in 10 instances were related to @entity295 or @entity5 . Three @entity1 who were skin-test responsive at the time of @entity204 died from cardiovascular causes. It is concluded that there is an increasing risk of the development of anergy to @entity56 antigens posttransplant and that the type of late mortality may be marked by this hyporeactive state.
