Vasculitis Need Not Stop Transplants

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Renal transplant recipients with systemic vasculitis do not have decreased patient or graft survival

 

Systemic vasculitis (SV) in renal transplant recipients does not significantly affect patient and graft survival, an Italian study found.

 

The study included 57 renal transplant recipients, of whom 19 had SV and 38 did not (controls). The mean post-transplant follow-up was 58 months for the vasculitis group and 61 months for controls.

 

The actuarial 10-year patient survival was 87% for the vasculitic patients and 90% for controls, the investigators reported in the American Journal of Transplantation (2007;7:2133-2139). The actuarial death-censored 10-year graft survival rate was 84% and 100%, respectively. The differences between the groups were not statistically significant.

 

The researchers, led by Gabriella Moroni, MD, of the IRCCS Ospedale Maggiore in Milan, found that severe infection requiring hospitalization occurred significantly more frequently in the vasculitic patients (74% vs. 34%). Vasculitis recurred in seven patients (36.8%) in a mean 45 months following transplantation.

 

Although graft function recovered in most relapses after reinforcement of immunosuppressive therapy, one patient died from hemophagoctic syndrome eight months after transplantation and two lost graft function. Another vasculitic patient died from lung cancer 26 months after transplantation. Two controls died, one from MI at 86 months and one from cerebral hemorrhage at 186 months.

 

The authors concluded that their results, “although based on a small sample size, underline that transplanted vasculitic subjects may have good patient and graft survival rates at 10 years, although infections were more frequent in vasculitic patients than in controls. Therefore, patients with SV may be considered as suitable candidates for renal transplantation.”

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