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PubMed

Záznam pochází z PubMed

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients

Nephrology, dialysis, transplantation. 2016 Jun ; 31 (6) : 1002-13. [epub] 20160112

Nephrol Dial Transplant
ISSN 1460-2385 | 0931-0509
Zdroj

Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz https://www.medvik.cz/link/pmid26763669

PubMed 26763669
DOI 10.1093/ndt/gfv437
PII: gfv437
Knihovny.cz E-zdroje

Klíčová slova
frequency, graft survival, kidney transplantation, minimally immunosuppressed patients, operational tolerance,
MeSH
dospělí MeSH
homologní transplantace MeSH
imunologická tolerance imunologie MeSH
imunosupresivní léčba metody MeSH
incidence MeSH
lidé MeSH
míra přežití trendy MeSH
přežívání štěpu imunologie MeSH
příjemce transplantátu * MeSH
průzkumy a dotazníky MeSH
rejekce štěpu epidemiologie imunologie prevence a kontrola MeSH
transplantace ledvin * MeSH
Check Tag
dospělí MeSH
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
Geografické názvy
Evropa epidemiologie MeSH

BACKGROUND: Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. METHODS: Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. RESULTS: One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still operationally tolerant. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. CONCLUSIONS: In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients

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