title: Kidney transplant from a living monozygotic twin donor with no maintenance immunosuppression.
abstract: From a theoretical point of view, an alloimmune response can not take place, still some type of standard immunosuppression is used in about 60% of patients receiving kidney grafts from their monozygotic twins. We aimed at assessing clinical response in patients receiving renal grafts from a living monozygotic twin 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 transplantation, 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 cardiovascular 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.
  
  
  CONCLUSIONS
  Kidney transplantation from a living monozygotic twin is associated to outstanding clinical outcomes. Immunossuppresive therapy to suppress alloimmune response in probably unnecessary 11 zygosity has been confirmed.
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España. Electronic address: asanchee@clinic.ub.es.
authors: Ana
authors: A
authors: Sánchez-Escuredo
authors: Sección de Nefrología, Hospital de Guadalajara, Guadalajara, México.
authors: Alberto
authors: A
authors: Barajas
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Ignacio
authors: I
authors: Revuelta
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Miquel
authors: M
authors: Blasco
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Federic
authors: F
authors: Cofan
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Núria
authors: N
authors: Esforzado
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: María José
authors: MJ
authors: Ricart
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Vicens
authors: V
authors: Torregrosa
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Josep Maria
authors: JM
authors: Campistol
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Federic
authors: F
authors: Oppenheimer
authors: Sección de Nefrología, Hospital Clinic Barcelona, Barcelona, España.
authors: Fritz
authors: F
authors: Diekmann
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007430:Intraoperative Care; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D014430:Twins, Monozygotic
chemical_list: D007166:Immunosuppressive Agents; D008775:Methylprednisolone
keywords: Immunosuppression; Inmunosupresión; Kidney transplant from living donor; Monocigotos; Monozygotes; Trasplante renal de donante vivo