Abstract: FR-PO1041
Retrospective Comparison of Kidney Transplant Outcomes with Different Induction Methods and Maintenance Prednisone in Patients with Systemic Sclerosis
Session Information
- Transplantation: Clinical - Pharmacology and Nonkidney Solid Organ Transplants
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Grigoryan, Lilit, Albany Medical Center, Albany, New York, United States
- Wajid, Sumbal, Albany Medical Center, Albany, New York, United States
- Salman, Jude L, Rensselaer Polytechnic Institute, Troy, New York, United States
- Monrroy, Mauricio, Albany Medical Center, Albany, New York, United States
- Faddoul, Giovanni, Albany Medical Center, Albany, New York, United States
- Mehta, Swati, Albany Medical Center, Albany, New York, United States
Background
Systemic sclerosis (SSc) or scleroderma is a systemic autoimmune disease with multi-organ involvement. Scleroderma renal crisis (SRC) is one of the life threatening complications of systemic sclerosis (SSc). Up to 20-50% require long term dialysis and subsequently kidney transplant. We performed a retrospective study using the United Network for Organ Sharing (UNOS) database, to compare the impact of different induction immunosuppression regimens and maintenance prednisone amongst our SSc cohort.
Methods
A retrospective analysis analyzed 211 patients with scleroderma who underwent KT from deceased donors (DD) and live donors (LD) using UNOS database from 2000-2022. Cox regression analyses were conducted for patient survival and graft survival for patients with SSc.
Results
There were statistically significant worse outcomes in graft survival in SSc patients receiving induction therapy with alemtuzamab (AB), and thymo+basiliximab/thymo+daclizumab as well as with maintenance prednisone (MP). There was no statistically significant difference in patient survival. Table1
Conclusion
AB was recently studied in a retrospective review of SSc patients which demonstrated significantly poorer graft survival which correlates with our findings as well. Like AB a recent study looked at death-censored graft failure in individuals receiving combination therapy with thymo+basiliximab and found a statistically significant increased rate of death censored graft failure which also aligns with our study.
We further found that MP use was associated with poorer graft survival. One hypothesis is that steroids may contribute to SRC recurrence after KT. Although the association between steroids and increased SRC risk is well established, data on post-transplant recurrence is limited. A 2005 case study documented two SRC recurrences, with the earlier event occurring in the patient on higher steroid doses.
Hazard ratios of graft and patient survival comparing different induction methods and maintenance prednisone among SSc cohort