*Purpose: Sickle cell disease (SCD) is an autosomal recessive hematological disorder caused by point mutation (substitution of valine for glutamine). There are about 100,000 patients with SCD in the US, and almost 2 million with sickle cell trait (SCT). 5-30% of them develop kidney dysfunction. The prevalence of end stage renal disease (ESRD) attributable to SCD is 1%. ESRD patients with SCD have higher morbidity and mortality compared to their matched cohorts with ESRD due to other causes. The data about kidney transplantation (KT) outcomes in SCD and SCT patients is sparse. The aim of this study was to examine patient and renal allograft survival post renal transplantation in these patients. Hematological and renal function were also compared.

*Methods: We queried the electronic medical records for all patients with SCD or SCT who underwent a KT in our center between 2010-2019. Each record was retrospectively reviewed for donor and recipient demographic, as well as readmissions, renal and hematological outcomes.

*Results: Of 9 patients, five had SCT, and four had SCD. All but one were African American, with 3 males and 6 females. Median age at time of KT was 47.8 years. Seven patients had deceased donors, with one patient undergoing simultaneous kidney-pancreas transplant. Median cPRA was 50.5%. Thymoglobulin was used for induction; tacrolimus and mycophenolate sodium for maintenance immunosuppression. With a median follow up of 43 months for SCT and 62 months for SCD, here were no deaths or allograft loss in this cohort. Mean of most current serum creatinine and hemoglobin were 1.8mg/dL (STD 0.88), and 10g/dL (STD 2.59), respectively.

*Conclusions: Patients with SCD are living longer, and thus enduring the weight of their substantial comorbidities, including development of ESRD. KT has long been proven to be the best form of therapy for ESRD, but some centers shy away from listing these patients for a KT. Although our cohort is small, it demonstrates excellent outcomes, for these patients with more than 40 months of follow up. Efforts must be taken to refer these patients to a transplant center in a timely fashion, so they can be benefitted by KT.

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