A new case series reports successful kidney transplantation in 3 patients with sickle cell disease (SCD) nephropathy, as published in the Indian Journal of Nephrology. The researchers reported that all 3 patients show good renal function 18, 24, and 48 months after the transplant.
“Currently, it has been proven that the survival of SCD patients following [kidney transplantation] has significantly improved with no significant overall survival difference between SCD patients and controls (end-stage renal disease patients from other causes),” the authors said.
“Though it may be difficult to comment on the long-term survival of both our patients and allografts due to our short follow-up duration, we can conclude that the short-term outcome has been encouraging with 100% survival at 2 years.”
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Patient 1 was a 39-year-old woman diagnosed with SCD at 2 years of age, whose kidney donor was her younger brother. The patient’s renal function normalized 3 days post-transplant. Patient 2 was a 47-year-old man with SCD and end-stage renal disease, whose donor was also his brother. His renal function normalized 5 days post-transplant.
Patient 3 was a 58-year-old man with severe anemia, chronic kidney disease, and gout arthritis. His donor was compatible in terms of the ABO blood group. He required drainage of the periallograft lymphocele 3 weeks after the transplant, but he is currently doing well and his renal function is normal.
To achieve the best outcomes of kidney transplantation, the authors emphasize the need for optimal donor and recipient selection and appropriate preoperative preparation for the transplant including hemodialysis, plasmapheresis, and correction of anemia. In addition, an important component of success appears to be having living and related kidney donors with good human leukocyte antigen compatibilities.
Igbokwe M, Olatise O, Faponle A, et al. Kidney transplantation in sickle cell disease patients: case series and experience from a Nigerian kidney transplant center. Indian J Nephrol. Published online March 9, 2022. doi:10.4103/ijn.IJN_28_20