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Abstract: FR-PO848

Kidney Transplant Outcomes in Patients With Scleroderma: A Single Center Experience

Session Information

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 Gender8 (88.9%)
Age in years61 (+/-4)
Patients on HD6 (66%)
Time on HD in years2.5 (+/-1)
Living Donor Transplant5 (55%)
Deceased Donor Transplant4 (45%)
ACE-i Post-Transplant9 (100%)
Graft Survival Rate (%) 
1 year100%
5 years100%
10 years78%