Saxena Nishkarsh, Djamali Arjang, Astor Brad C, Mohamed Maha, Mandelbrot Didier, Parajuli Sandesh
Clin Nephrol. 2017 Jul;88(1):40-44. doi: 10.5414/CN109107.
There is limited information on kidney transplant recipients with end-stage renal disease (ESRD) due to scleroderma. We conducted an observational study on kidney transplant recipients with ESRD due to scleroderma who received kidney transplant at our center between 01/1994 and 06/2013. During the study period, there were 10 kidney transplant recipients, all of whom were Caucasian females. Seven of them were living-donor kidney transplant recipients, and the mean age at time of transplant was 56.6 ± 11.99 years. The mean post-transplant follow-up was 76.75 ± 56.18 months; the mean dialysis vintage was 46.4 ± 80.35 months, ranging from 8 to 272 months; and the mean serum creatinine (Cr) levels at 3, 6, and 12 months were 1.31 ± 0.47 mg/dL, 1.35 ± 0.51 mg/dL, and 1.34 ± 0.49 mg/dL, respectively. There were 5 graft failures with median graft survival of 101 months. None had recurrence of scleroderma renal crisis. In those without graft failure, the mean serum Cr at last follow-up was 0.96 ± 0.39 mg/dL. Six patients were on angiotensin converting enzyme inhibitors (ACE-I) after transplant. In univariate analysis, none of the factors including, age at time of transplant, dialysis vintage, use of ACE-I, living-donor transplant, cytomegalovirus infection, and serum Cr at 1 year were predictive of graft failure. In our study, we hoped to find outcomes and various factors associated with graft failure in these patients. We found a wide variation in outcomes after kidney transplantation. More studies are needed to assess the factors that may influence the graft survival in this rare disease. .
关于硬皮病所致终末期肾病(ESRD)肾移植受者的信息有限。我们对1994年1月至2013年6月期间在本中心接受肾移植的硬皮病所致ESRD肾移植受者进行了一项观察性研究。研究期间,有10例肾移植受者,均为白人女性。其中7例为活体供肾肾移植受者,移植时的平均年龄为56.6±11.99岁。移植后的平均随访时间为76.75±56.18个月;平均透析时间为46.4±80.35个月,范围为8至272个月;3个月、6个月和12个月时的平均血清肌酐(Cr)水平分别为1.31±0.47mg/dL、1.35±0.51mg/dL和1.34±0.49mg/dL。有5例移植失败,移植存活时间中位数为101个月。无一例发生硬皮病肾危象复发。在未发生移植失败的患者中,最后一次随访时的平均血清Cr为0.96±0.39mg/dL。6例患者移植后使用血管紧张素转换酶抑制剂(ACE-I)。单因素分析中,包括移植时年龄、透析时间、ACE-I的使用、活体供肾移植、巨细胞病毒感染和1年时的血清Cr等因素均不能预测移植失败。在我们的研究中,我们希望找出这些患者移植失败的结局及各种相关因素。我们发现肾移植后的结局差异很大。需要更多研究来评估可能影响这种罕见疾病移植存活的因素。