Output of peritoneal cells during peritoneal dialysis

SUMMARY Peritoneal dialysis provides a good source for the collection of macrophages. Six patients with chronic renal failure undergoing peritoneal dialysis for the first time were studied, and maximum cell egress, mostly macrophages, occurred at 24-48 hours and diminished after 48 hours. Collection of monocytes from peripheral blood is a cumbersome procedure and the yield is low. Human macrophages, together with other white cells, were obtained in large quantities from peritoneal dialysis fluid of patients undergoing dialysis for renal failure and were used therapeutically to combat infections in patients with uncontrolled leukaemia, who were no longer responding to antibiotics. The trans-fusion of peritoneal cells had no obvious side effects (Fakhri et al., 1976a), and earlier in vitro experiments (Fakhri et al., 1976b) suggested that macrophages lack the immunogens that generate the mixed lymphocyte reaction (lymphocyte-determined LD antigens). Furthermore, macrophages (Tj = 71 hours; Whitelaw, 1972) can enjoy much longer life than neutrophils (Tk = 6 hours) and might thereby be more beneficial. The number of lymphocytes and other white cells present with macrophages in the dose of peritoneal cells given was initially too small to cause any side effects, but such cells should be first irradiated with 1500 rads to prevent any subse-quent risk of graft-versus-host disease in immuno-logically depressed recipients. The number of peritoneal cells and the percentage of macrophages in them varied with time after dialysis. In this paper we present a study of the peritoneal cells removed by dialysis. Such in-formation may be a useful guideline for those intending to use the macrophages therapeutically, or as a substitute for white cell transfusions, especi-ally in centres where leucopheresis units are not available. Material and methods Patients with chronic renal failure, who require