title: Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study.
abstract: Kidney transplantation is one of the therapeutic options for end-stage renal disease (ESRD) in systemic sclerosis (SS). Current evidence demonstrates poorer patient and graft survival after transplantation in SS than in other primary kidney diseases. All the patients presenting ESRD associated with SS who had received a kidney allograft between 1987 and 2013 were systematically included from 20 French kidney transplantation centres. Thirty-four patients received 36 kidney transplants during the study period. Initial kidney disease was scleroderma renal crisis in 76.4%. Extrarenal involvement of SS was generally stable, except cardiac and gastrointestinal involvements, which worsened after kidney transplantation in 45% and 26% of cases, respectively. Patient survival was 100%, 90.3% and 82.5% at 1, 3 and 5 years post-transplant, respectively. Pulmonary involvement of SS was an independent risk factor of death after transplantation. Death-censored graft survival was 97.2% after 1 and 3 years, and 92.8% after 5 years. Recurrence of scleroderma renal crisis was diagnosed in three cases. In our study, patient and graft survivals after kidney transplantation can be considered as excellent. On this basis, we propose that in the absence of extrarenal contraindication, SS patients presenting with ESRD should be considered for kidney transplantation.
authors.affiliation: Nephrology Dialysis Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, Haute-Normandie, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Bertrand
authors.affiliation: Nephrology Dialysis Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, Haute-Normandie, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Dehay
authors.affiliation: Department of Nephrology and Renal Transplantation, Hopitaux Universitaires de Strasbourg, Strasbourg, Alsace, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Ott
authors.affiliation: Service de Transplantation et Unité de soins intensifs, Hôpital Necker, Paris, France.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sberro
authors.affiliation: Nephrology and Transplantation, CHU Grenoble, Grenoble, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Brunelle
authors.affiliation: Department of Nephrology and Organ Transplantation Toulouse, CHU Rangueil, Haute Garonne, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.affiliation: Nephrology Dialysis Transplantation, CHU Reims, Reims, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Colosio
authors.affiliation: Nephrology Dialysis Transplantation, CHU Caen, Caen, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Chatelet
authors.affiliation: Nephrology-Dialysis-Transplantation, Nice University Hospital, Nice, PACA, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Albano
authors.affiliation: Nephrology Dialysis Transplantation, CHU Nancy, Nancy, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Girerd
authors.affiliation: Hopital Henri Mondor Creteil, Île-de-France, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Audard
authors.affiliation: Nephrology Dialysis Transplantation, CHU Tours, Tours, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Barbet
authors.affiliation: Nephrology Dialysis Transplantation, Centre Hospitalier Universitaire, Nantes, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Dantal
authors.affiliation: Department of Nephrology, CHU Besançon, Besançon, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Ducloux
authors.affiliation: Nephrology and Transplantation, Hôpital Bicètre, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Durrbach
authors.affiliation: Nephrology Transplantation, CHU Montpellier, Montpellier, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Garrigue
authors.affiliation: Service de Néphrologie, CHRU Lille, Lille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Hazzan
authors.affiliation: Service de Néphrologie, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Anne-Elisabeth
authors.initials: AE
authors.lastname: Heng
authors.affiliation: Nephrology Dialysis Transplantation, CHU Saint Etienne, Saint Etienne, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariat
authors.affiliation: Transplantation Rénale, CHU Bordeaux, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Merville
authors.affiliation: Nephrology Transplantation, CHU Limoges, Limoges, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Rerolle
authors.affiliation: Department of Nephrology and Renal Transplantation, Hopitaux Universitaires de Strasbourg, Strasbourg, Alsace, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.affiliation: Nephrology Dialysis Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, Haute-Normandie, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Guerrot
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005602:France; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications / Q000601:surgery*
keywords: graft and patient survival; kidney transplantation; systemic sclerosis