[Cellular immunity in dialysis patients using the lymphocyte transformation test (LTT) in comparison to conservatively treated patients with chronic terminal renal failure].

By means of the lymphocyte transformation test (LTT), using the mitogens phytohemagglutinin (PHA), concanavalin A (ConA), lipopolysaccharide (LPS) E. coli and the antigens tuberculin (PPD) and O-streptolysin, a contribution should be made for the judgment of the functional capacity of the immune system--in particular of the cellular immunity--in uraemia patients with and without dialysis therapy. In 33 patients with different duration of the dialysis (0.5 to 130 months) and 15 retention patients who were not yet treated by means of dialysis the LTT was controlled with stimulant agents mentioned above. In these cases was shown that dialysis patients managed metabolically regularly did not show a significant restriction of the cellular immunity in the LTT (PHA-stimulation over 0.55 transformed cells, con-A-stimulation over 0.37 transformed cells). The not dialysed patients with chronic uraemia showed a distinct diminution of the unspecific T-cell transformation by PHA and ConA, whereas the antigen-induced stimulation (PPD, O-streptolysin) was not disturbed in this case as well. In the two cases the B-cell transformation (on LPS) was not significantly disturbed. There was a good concordance with the clinical findings: scarcely general infects, no shunt infections, relatively many organ losses by rejection after transplantation in the dialysis patients. The not yet dialysed retention patients revealed clinically a higher inclination to an infect. There were no own experiences about the course after transplantation without preceding dialysis. It is discussed in how far also immunological investigations may play a role in the establishment of the optimum management of the dialysis, the moment of the beginning with the dialysis and for the "more individual preparation of the transplantation".