The haematological, biochemical and clinical features of six patients with polycythaemia after renal transplantation were studied. The patients had an absolute increase in red cell mass, but normal plasma and whole blood volumes. Primary proliferative polycythaemia was excluded. Polycythaemia developed within one year of transplantation and persisted for 3-7 years. Chronic rejection, renal artery stenosis, severe hypertension and corticosteroid therapy were probably not the cause of the polycythaemia. There were no occlusive vascular lesions during the observation period and venesections were generally not required. The polycythaemia is probably the result of the cumulative production of erythropoietin by the donor and recipient kidneys.
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