Renal transplantation in patients with sarcoidosis: a French multicenter study.
OBJECTIVE
Sarcoidosis is a multisystem disorder of unknown etiology. The outcome of renal transplantation on patients with sarcoidosis is not well known. A few case reports have described recurrence of sarcoidosis after transplant. Here, we report for the first time results and outcome of renal transplantation in a series of patients with sarcoidosis.


METHODS
Eighteen patients with sarcoidosis who underwent renal transplantation were identified retrospectively in eight French renal transplantation departments. Patient medical charts, demographics, and the outcome of renal transplantation were reviewed.


RESULTS
Initial renal disease was related to sarcoidosis in 10 patients. At the end of the follow-up (median, 42 months), patient and death-censored graft survival were 94.4% and the mean GFR was 60 ml/min per 1.73 m(2). Five patients (27%) experienced recurrence of sarcoidosis including extra-renal involvement in two patients and renal involvement in three patients. Median GFR was lower in the group of patients with renal recurrence compared with that of the entire cohort: 31 ml/min per 1.73 m(2). Recurrence occurred shortly after transplantation (median period, 13 months). Risk factors for recurrence included primary renal disease related to sarcoidosis and a shorter delay between the last episode of sarcoidosis and renal transplantation.


CONCLUSIONS
Our results indicate that renal transplantation may be carried out safely in transplant candidates with sarcoidosis. Recurrence is not rare and is likely to affect graft outcome. These results fully justify a specific clinical and histologic monitoring mainly during the early posttransplant period.
Aouizerate
Jessie
J
Nephrology and Transplantation Department, Henri Mondor Hospital, AP-HP, Institut Francilien de Recherche en Néphrologie et Transplantation and Paris XII University, Créteil, France.
Matignon
Marie
M
Kamar
Nassim
N
Thervet
Eric
E
Randoux
Christine
C
Moulin
Bruno
B
Raffray
Loic
L
Buchler
Matthias
M
Villar
Emmanuel
E
Mahevas
Mathieu
M
Desvaux
Dominique
D
Dahan
Karine
K
Diet
Carine
C
Audard
Vincent
V
Lang
Philippe
P
Grimbert
Philippe
P
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005602:France; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012507:Sarcoidosis / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents