Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression

Standard immunosuppression is used in about 60% of patients receiving kidney grafts from their monozygotic twins living donor although an alloimmune response can not take place. The aim of the study was to asses the clinical response in patients receiving renal grafts from a monozygotic twin living...

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Main Authors: Ana Sánchez-Escuredo, Alberto Barajas, Ignacio Revuelta, Miquel Blasco, Federic Cofan, Núria Esforzado, María José Ricart, Vicens Torregrosa, Josep Maria Campistol, Federic Oppenheimer, Fritz Diekmann
Format: Article
Language:English
Published: Elsevier 2015-07-01
Series:Nefrología (English Edition)
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2013251415000577
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author Ana Sánchez-Escuredo
Alberto Barajas
Ignacio Revuelta
Miquel Blasco
Federic Cofan
Núria Esforzado
María José Ricart
Vicens Torregrosa
Josep Maria Campistol
Federic Oppenheimer
Fritz Diekmann
author_facet Ana Sánchez-Escuredo
Alberto Barajas
Ignacio Revuelta
Miquel Blasco
Federic Cofan
Núria Esforzado
María José Ricart
Vicens Torregrosa
Josep Maria Campistol
Federic Oppenheimer
Fritz Diekmann
author_sort Ana Sánchez-Escuredo
collection DOAJ
description Standard immunosuppression is used in about 60% of patients receiving kidney grafts from their monozygotic twins living donor although an alloimmune response can not take place. The aim of the study was to asses the clinical response in patients receiving renal grafts from a monozygotic twin living donor when no immunosuppressive therapy is used. Methods: This is a retrospective observational study of patients receiving kidney grafts from their monozygotic twins from 1969 to 2013. The following data were recorded: age, renal graft recipient's primary disease, renal function, renal survival and overall survival. Immunosuppressive therapy included a single intraoperative dose of methylprednisolone 500 mg and no maintenance immunosuppression. Results: Five patients with kidney grafts from their monozygotic twins were dentified in our centre. Mean age at transplantation was 33 years (27–39). One-year overall survival and graft survival were 100%. Mean creatinine level was 0.96 ± 0.2 one year after transplanta tion, and 1.2 ± 0.37 mg/dl at most recent follow-up. Two patients died with a functional graft more than 15 years after kidney transplantation (causes were melanoma and cardiovascu lar event respectively). Follow-up was lost in a patient one year after transplantation. Two patients are alive with a functioning graft at 18 months and 42.5 years after transplantation respectively. Conclusion: Kidney transplantation from a monozygotic twin living donor is associated with excellent clinical outcomes. Immunosuppressive therapy to suppress alloimmune response is probably unnecessary if zygosity has been confirmed.
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spelling doaj.art-289d1571c5c84c3ca6cbaea413d680542022-12-22T00:32:18ZengElsevierNefrología (English Edition)2013-25142015-07-0135435836210.1016/j.nefroe.2015.02.004Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppressionAna Sánchez-Escuredo0Alberto Barajas1Ignacio Revuelta2Miquel Blasco3Federic Cofan4Núria Esforzado5María José Ricart6Vicens Torregrosa7Josep Maria Campistol8Federic Oppenheimer9Fritz Diekmann10Sección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital de Guadalajara, Guadalajara, MexicoSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainSección de Nefrología, Hospital Clínic Barcelona, Barcelona, SpainStandard immunosuppression is used in about 60% of patients receiving kidney grafts from their monozygotic twins living donor although an alloimmune response can not take place. The aim of the study was to asses the clinical response in patients receiving renal grafts from a monozygotic twin living donor when no immunosuppressive therapy is used. Methods: This is a retrospective observational study of patients receiving kidney grafts from their monozygotic twins from 1969 to 2013. The following data were recorded: age, renal graft recipient's primary disease, renal function, renal survival and overall survival. Immunosuppressive therapy included a single intraoperative dose of methylprednisolone 500 mg and no maintenance immunosuppression. Results: Five patients with kidney grafts from their monozygotic twins were dentified in our centre. Mean age at transplantation was 33 years (27–39). One-year overall survival and graft survival were 100%. Mean creatinine level was 0.96 ± 0.2 one year after transplanta tion, and 1.2 ± 0.37 mg/dl at most recent follow-up. Two patients died with a functional graft more than 15 years after kidney transplantation (causes were melanoma and cardiovascu lar event respectively). Follow-up was lost in a patient one year after transplantation. Two patients are alive with a functioning graft at 18 months and 42.5 years after transplantation respectively. Conclusion: Kidney transplantation from a monozygotic twin living donor is associated with excellent clinical outcomes. Immunosuppressive therapy to suppress alloimmune response is probably unnecessary if zygosity has been confirmed.http://www.sciencedirect.com/science/article/pii/S2013251415000577Kidney transplant from living donorImmunosuppressionMonozygotes
spellingShingle Ana Sánchez-Escuredo
Alberto Barajas
Ignacio Revuelta
Miquel Blasco
Federic Cofan
Núria Esforzado
María José Ricart
Vicens Torregrosa
Josep Maria Campistol
Federic Oppenheimer
Fritz Diekmann
Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
Nefrología (English Edition)
Kidney transplant from living donor
Immunosuppression
Monozygotes
title Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
title_full Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
title_fullStr Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
title_full_unstemmed Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
title_short Kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
title_sort kidney transplant from a monozygotic twin living donor with no maintenance immunosuppression
topic Kidney transplant from living donor
Immunosuppression
Monozygotes
url http://www.sciencedirect.com/science/article/pii/S2013251415000577
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