Renal transplantation without maintenance immunosuppression. Identical twins and kidney transplantation following a successful bone marrow graft

Abstract

Renal transplantation without maintenance immunosuppression has been sporadically reported in the literature. The cases include non-adherent patients who discontinued their immunosuppressive medications, transplantation between identical twins, kidney transplantation after a successful bone marrow graft from the same donor and simultaneous bone marrow and kidney transplantation for the treatment of multiple myeloma with associated renal failure. There are also ongoing clinical trials designed to induce donor specific transplant tolerance with infusion of hematopoietic cells from the same kidney donor. Here we describe two cases of renal transplantation without immunosuppression as examples of situations described above.

<b>Adesão à terapia imunossupressora em receptores de transplante renal/ Adherence to immunosuppressive therapy adherence in kidney transplant recipients<b>

“…É uma terapia que necessita do uso contínuo de drogas imunossupressoras para manutenção do enxerto renal. Sem imunossupressão efetiva o enxerto está sujeito a resultados clínicos desfavoráveis, como rejeição e menor sobrevida (2) . Em transplante renal, a adesão à terapia imunossupressora é fundamental para a sobrevivência do enxerto em longo prazo (3) .…”