A new predictive factor for the outcome of renal transplantation.

The cell mediated immunity (CMI) of a group of patients on regular haemodialysis was measured using a modified dinitrochlorobenzene (DNCB) skin test. The strength of the reaction was graded from 0 to 15 on an objective scale which we called the DNCB index. This index was much reduced in the dialysis patients in comparison with a group of healthy controls. Thirty-six dialysis patients were subsequently transplanted and graft survival was assessed at six months. A significantly higher graft failure rate was observed in those with a strong skin reaction than in those with a weak or absent response (P less than 0.01). While the mean DNCB is much lower than normal in dialysis patients, there is a wide variation within this group. We have found that the DNCB index correlates well with renal allograft survival suggesting that this skin test has value in the prediction of transplant outcome.