The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients.

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  • dc.contributor.author Massart, Annickca
  • dc.contributor.author Pascual Santos, Julioca
  • dc.contributor.author Abramowicz, Danielca
  • dc.date.accessioned 2016-05-26T09:28:14Z
  • dc.date.issued 2016
  • dc.description.abstract BACKGROUND: Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. METHODS: Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. RESULTS: One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still operationally tolerant. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. CONCLUSIONS: In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.ca
  • dc.description.sponsorship This survey was funded by the ERA-EDTA-DESCARTES working group, the Fonds Erasme (research grant), the Fonds Carine Vyghen, the Fonds Horlait-Dapsens, the RTRS Fondation de Coopération Scientifique CENTAURE and the IHUCesti project, which received French government financial support managed by the National Research Agency via the ‘Investment Into The Future’ program ANR-10-IBHU-005. J.Pascual is supported by FIS-FEDER PI13/00598 and REDINREN RD12/0021/0024
  • dc.format.mimetype application/pdfca
  • dc.identifier.citation Massart A, Pallier A, Pascual J, Viklicky O, Budde K, Spasovski G. et al. The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients. Nephrol Dial Transplant. 2016 Jun;31(6):1002-13. doi: 10.1093/ndt/gfv437.ca
  • dc.identifier.doi http://dx.doi.org/10.1093/ndt/gfv437
  • dc.identifier.issn 0931-0509
  • dc.identifier.uri http://hdl.handle.net/10230/26758
  • dc.language.iso engca
  • dc.publisher Oxford University Pressca
  • dc.relation.ispartof Nephrology Dialysis Transplantation. 2016 Jun;31(6):1002-13
  • dc.rights c) Oxford University Press. This is a pre-copy editing, author-produced PDF of an article accepted for publication in Nephrology Dialysis Transplantation following peer review. The definitive publisher -authenticated version Massart A, Pallier A, Pascual J, Viklicky O, Budde K, Spasovski G. et al. The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients. Nephrol Dial Transplant. 2016 Jun;31(6):1002-13 i avalaible online at: http://dx.doi.org/10.1093/ndt/gfv437ca
  • dc.rights.accessRights info:eu-repo/semantics/openAccessca
  • dc.subject.other Ronyons -- Trasplantació -- Aspectes immunològicsca
  • dc.title The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients.ca
  • dc.type info:eu-repo/semantics/articleca
  • dc.type.version info:eu-repo/semantics/acceptedVersionca

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