Tumour necrosis factor levels during acute rejection and acute tubular necrosis in renal transplant recipients

Plasma tumour necrosis factor levels were measured serially in 16 patients following renal transplantation, and in 10 patients on haemodialysis and in 12 patients on peritoneal dialysis. The patients on peritoneal dialysis ha d lower plasma TNF levels than the patients on haemodialysis. There was a d ecrease in TNF levels immediately following renal transplantation; this is probably related to the bolus doses of methylprednisolone administered intr a-operatively. Patients with acute rejection had higher levels of TNF than non-rejecting patients. The increase in TNF levels in rejecting patients wa s observed 2 days before the clinical manifestation of acute rejection. The re was a marked decrease in TNF levels in rejecting patients in response to treatment with steroids. Patients with delayed graft function had higher l evels of TNF on the first post-operative day compared to patients with imme diate function. These changes in plasma TNF levels following. renal transpl antation have important clinical and therapeutic implications. (C) 2000 Els evier Science B.V. All rights reserved.