title: A lesson from kidney transplantation among identical twins: Case report and literature review.
abstract: There continues to be disagreement related to the appropriate therapeutic regimen to be used when the donor and the recipient in kidney transplant operations are identical twins. Here we present two cases of kidney transplantation between identical twins. Both recipients had end-stage renal disease (ESRD) caused by primary nephropathy. We also present information gleaned from a literature review of similar cases. The first recipient was a 26-year-old man who experienced biopsy-proven IgA nephropathy 10 months post-transplantation. Mycophenolate mofetil (MMF), angiotensin receptor blockers (ARBs), and steroids were used to reverse this pathologic condition. Till now, 76 months post-transplantation, the patient is stable, and the new kidney is functioning well. The second recipient was a 20-year-old woman who had hematuria and proteinuria 3 months post-transplantation, and crescent glomerulonephritis with mild to moderate interstitial injury was proven by biopsy 11 months postoperatively. This patient did not respond to various treatments and resumed hemodialysis 15 months post-transplantation. These case studies show that immunosuppressive therapy should be maintained in kidney transplant recipients who are identical twins with ESRD caused by initial nephropathy.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu 610041 Sichuan, People's Republic of China.
authors.forename: Zhengsheng
authors.initials: Z
authors.lastname: Rao
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu 610041 Sichuan, People's Republic of China.
authors.forename: Zhongli
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu 610041 Sichuan, People's Republic of China.
authors.forename: Turun
authors.initials: T
authors.lastname: Song
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu 610041 Sichuan, People's Republic of China.. Electronic address: kidney5@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Lin
mesh_terms: D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D005260:Female; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D014430:Twins, Monozygotic
chemical_list: D057911:Angiotensin Receptor Antagonists; D009173:Mycophenolic Acid
keywords: Identical twins; Immunosuppression; Kidney transplantation