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一项针对十名因硬皮病导致终末期肾病的白人女性的单中心肾移植经验 。

A single center kidney transplant experience among ten Caucasian females with end-stage renal disease due to scleroderma
.

作者信息

Saxena Nishkarsh, Djamali Arjang, Astor Brad C, Mohamed Maha, Mandelbrot Didier, Parajuli Sandesh

出版信息

Clin Nephrol. 2017 Jul;88(1):40-44. doi: 10.5414/CN109107.

DOI:10.5414/CN109107
PMID:28406085
Abstract

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.
.

摘要

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。

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