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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
This summary is machine-generated.

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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.

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.

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  • 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.