In the first three weeks after kidney transplantation the patients were examined for daily changes in immunoglobulin levels. Only very seldom was a decrease of IgM detected in our patients who had undergone splenectomy. During half of the rejection crisis there were indeed short periods of increase (spikes) in immunoglobulins. These were observed always before or concomitantly with the clinical diagnosis of a rejection reaction. In order to determine the connection between immunoglobulin-spikes and an approaching rejection episode the general one-sided binominal test was used. A significant relation was established between IgM peaks and an approaching rejection crisis. No such relation could be found for the IgA peaks observed. The IgG globulins showed no consistent pattern during a transplantation rejection. A persistent fall of the IgG globulins was noted in the first ten days after renal allograft with the immunosuppressive regimen of an initial gramme of methylprednisolon and high dosage of azothioprine. A good correlation was observed with the simultaneous depression of serum albumin concentrations. As losses of protein in urine are minimal (already confirmed by other authors), it must be assumed that in the first place a high rate of catabolism and a restriction in the protein synthesis is responsible for the decrease in the IgG globulins and the serum albumins.
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