Long‑term survival in a recipient of kidney transplant without maintenance immunosuppression: A case report

Feng,Sujuan; Zhuang,Yuan; Liu, Hang; Zhang,Xiaodong

doi:10.3892/etm.2018.6176

Long‑term survival in a recipient of kidney transplant without maintenance immunosuppression: A case report

Authors:
- Sujuan Feng
- Yuan Zhuang
- Hang Liu
- Xiaodong Zhang
View Affiliations

Affiliations: Institute of Uro‑Nephrology, Beijing Chao‑Yang Hospital, Capital Medical University, Beijing 100020, P.R. China, Department of Blood Transfusion, Chinese PLA General Hospital, Beijing 100853, P.R. China
Published online on: May 17, 2018 https://doi.org/10.3892/etm.2018.6176
Pages: 360-363

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Operational tolerance of an allograft kidney is the optimal condition in patients following kidney transplantation and recipient‑mediated immunological rejection still remains the primary challenge following transplantation. In the present study, a case of long‑term survival is reported in a patient following kidney transplantation without maintenance immunosuppression therapies for >10 years. Although the pathological conditions of the transplanted kidney revealed a degree of impaired kidney function, the patient exhibited a serum creatinine level of 119.2 µmol/l and no significant changes were observed in T or B cell biomarkers associated with immunologic tolerance. Notably, the patient's allograft was functioning normally. Consequently, further studies may need to elucidate the development of operational tolerance.

View Figures

View References

1	Newell KA and Turka LA: Tolerance signatures in transplant recipients. Curr Opin Organ Transplant. 20:400–405. 2015. View Article : Google Scholar : PubMed/NCBI
2	Głyda M, Czapiewski W, Karczewski M, Pięta R and Oko A: Influence of donor and recipient gender as well as selected factors on the five-year survival of kidney graft. Pol Przegl Chir. 83:188–195. 2011. View Article : Google Scholar : PubMed/NCBI
3	Marcén R: Immunosuppressive drugs in kidney transplantation: Impact on patient survival, and incidence of cardiovascular disease, malignancy and infection. Drugs. 69:2227–2243. 2009. View Article : Google Scholar : PubMed/NCBI
4	Marchetti P and Navalesi R: The metabolic effects of cyclosporin and tacrolimus. J Endocrinol Invest. 23:482–490. 2000. View Article : Google Scholar : PubMed/NCBI
5	Okonkwo IN, Ogbu II, Ijoma UN, Ulasi II and Ijoma CK: Reference intervals for serum cystatin C and creatinine of an indigenous adult Nigerian population. Niger J Clin Pract. 18:173–177. 2015. View Article : Google Scholar : PubMed/NCBI
6	Luippold G, Benöhr P, Piesch C, Heyne N and Mühlbauer B: Urinary dopamine excretion in healthy volunteers: Effect of sodium diet and acute water load. Pflugers Arch. 440:28–33. 2000. View Article : Google Scholar : PubMed/NCBI
7	Luan Y, Mosheir E, Menon MC, Wilson D, Woytovich C, Ochando J and Murphy B: Monocytic myeloid-derived suppressor cells accumulate in renal transplant patients and mediate CD4(+) Foxp3(+) Treg expansion. Am J Transpl. 13:3123–3131. 2013. View Article : Google Scholar
8	Owen RD: Immunogenetic consequences of vascular anastomoses between bovine twins. Science. 102:400–401. 1945. View Article : Google Scholar : PubMed/NCBI
9	Billingham RE, Brent L and Medawar PB: Actively acquired tolerance of foreign cells. Nature. 172:603–606. 1953. View Article : Google Scholar : PubMed/NCBI
10	Girmanova E, Hruba P and Viklicky O: Circulating biomarkers of tolerance. Transpl Rev (Orlando). 29:68–72. 2015. View Article : Google Scholar
11	Orlando G, Hematti P, Stratta RJ, Burke GW III, Di Cocco P, Pisani F, Soker S and Wood K: Clinical operational tolerance after renal transplantation: Current status and future challenges. Ann Surg. 252:915–928. 2010. View Article : Google Scholar : PubMed/NCBI
12	Brouard S, Mansfield E, Braud C, Li L, Giral M, Hsieh SC, Baeten D, Zhang M, Ashton-Chess J, Braudeau C, et al: Identification of a peripheral blood transcriptional biomarker panel associated with operational renal allograft tolerance. Proc Natl Acad Sci USA. 104:15448–15453. 2007. View Article : Google Scholar : PubMed/NCBI
13	Heidt S and Wood KJ: Biomarkers of operational tolerance in solid organ transplantation. Exp Opin Med Diagn. 6:281–293. 2012. View Article : Google Scholar
14	Sakaguchi S: Regulatory T cells: Key controllers of immunologic self-tolerance. Cell. 101:455–458. 2000. View Article : Google Scholar : PubMed/NCBI
15	Louis S, Braudeau C, Giral M, Dupont A, Moizant F, Robillard N, Moreau A, Soulillou JP and Brouard S: Contrasting CD25hiCD4+T cells/FOXP3 patterns in chronic rejection and operational drug-free tolerance. Transplantation. 81:398–407. 2006. View Article : Google Scholar : PubMed/NCBI
16	Krepsova E, Tycova I, Sekerkova A, Wohlfahrt P, Hruba P, Striz I, Sawitzki B and Viklicky O: Effect of induction therapy on the expression of molecular markers associated with rejection and tolerance. BMC Nephrol. 16:1462015. View Article : Google Scholar : PubMed/NCBI
17	Kopchaliiska D, Zachary AA, Montgomery RA and Leffell MS: Reconstitution of peripheral allospecific CD19+ B-cell subsets after B-lymphocyte depletion therapy in renal transplant patients. Transplantation. 87:1394–1401. 2009. View Article : Google Scholar : PubMed/NCBI
18	Kawai T, Cosimi AB, Colvin RB, Powelson J, Eason J, Kozlowski T, Sykes M, Monroy R, Tanaka M and Sachs DH: Mixed allogeneic chimerism and renal allograft tolerance in cynomolgus monkeys. Transplantation. 59:256–262. 1995. View Article : Google Scholar : PubMed/NCBI
19	Kawai T, Sachs DH, Sprangers B, Spitzer TR, Saidman SL, Zorn E, Tolkoff-Rubin N, Preffer F, Crisalli K, Gao B, et al: Long-term results in recipients of combined HLA-mismatched kidney and bone marrow transplantation without maintenance immunosuppression. Am J Transpl. 14:1599–1611. 2014. View Article : Google Scholar