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Related Experiment Videos

Renal transplantation in scleroderma.

Y J Chang1, H Spiera

  • 1Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA.

Medicine
|November 27, 1999
PubMed
Summary

Renal transplantation is a viable treatment for systemic sclerosis patients with kidney failure, showing graft survival comparable to systemic lupus erythematosus patients. Consider transplantation for scleroderma renal crisis unresponsive to ACE inhibitors.

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Area of Science:

  • Nephrology
  • Immunology
  • Rheumatology

Background:

  • Limited data exist on renal transplantation outcomes for systemic sclerosis (SSc) patients.
  • Systemic lupus erythematosus (SLE) transplantation outcomes are well-documented, providing a comparative benchmark.

Observation:

  • A retrospective analysis of 86 SSc patients undergoing renal transplantation between 1987-1997 was conducted.
  • Overall mortality was 24%, with 44% graft failure within the study period.
  • Five-year graft survival rates ranged from 47% to 62%.

Findings:

  • Graft failure causes were often undetermined (63%); known causes included acute/chronic rejection, SSc recurrence, infection, and thrombosis.
  • Cyclosporine use did not significantly improve graft survival or increase failure rates in SSc patients.
  • Five-year graft survival in SSc patients was comparable to that reported for SLE patients.

Implications:

  • Renal transplantation is an effective treatment for SSc patients with end-stage renal disease, similar to its efficacy in SLE patients.
  • SSc patients with scleroderma renal crisis refractory to ACE inhibitors should be evaluated for renal transplantation.
  • Cyclosporine's benefit in improving graft survival for SSc patients remains uncertain compared to SLE patients.

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