Abstract: FR-PO848
Kidney Transplant Outcomes in Patients With Scleroderma: A Single Center Experience
Session Information
- Transplantation: Clinical - Outcomes
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Portocarrero Caceres, Juan Pablo, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
- Ghossein, Cybele, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
- Tawhari, Ibrahim, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
Background
Scleroderma Renal Crisis (SRC) is a devastating complication of Scleroderma (SSc) affecting 5-20% of all SSc patients. End stage kidney disease (ESKD) develops in 25-40% of SRC patients. Kidney transplantation (KT) is a viable option for patients that progress to ESKD, but little data exists on outcomes in this population. Here we report on patient and graft outcomes in a case series of SSc patients undergoing KT.
Methods
This was a retrospective study of all patients with SSc who underwent KT at Northwestern Hospital between 2000 and 2020. The objective of this study were to determine graft and patient survival at year 1, 5 and 10 post-transplant.
Results
Nine patients (eight females and one male) with SSc underwent KT. All the patients had diffuse SSc . Six patients were on HD and three had preemptive transplantation. Five patients had a Living Donor KT (LDKT) while 4 had a deceased donor KT (DDKT). Only one patient had delayed graft function. Standard immunosuppression was used as induction and maintenance. All patients were maintained on ace inhibitors post-transplant. Graft survival at 1, 5 and 10 years was 100%, 100% and 78% respectively (Table 1). The survival rate in our cohort was similar to graft survival. Two patients had recurrence of SRC at 3 and 6 years respectively after transplant[GC1] , leading to ESKD.
Conclusion
KT is a viable option for patients with ESKD due to SSC with acceptable graft and patient survival. Recurrence of SRC while rare can occur years after initial KT .
Table 1. Clinical characteristics and outcomes of KT in SSc patients
| Female Gender | 8 (88.9%) |
| Age in years | 61 (+/-4) |
| Patients on HD | 6 (66%) |
| Time on HD in years | 2.5 (+/-1) |
| Living Donor Transplant | 5 (55%) |
| Deceased Donor Transplant | 4 (45%) |
| ACE-i Post-Transplant | 9 (100%) |
| Graft Survival Rate (%) | |
| 1 year | 100% |
| 5 years | 100% |
| 10 years | 78% |