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

Annick Massart; Annaïck Pallier; Julio Pascual; Ondrej Viklicky; Klemens Budde; Goce Spasovski; Marian Klinger; Mehmet Sukru Sever; Søren Schwartz Sørensen; Karine Hadaya; Rainer Oberbauer; Christopher Dudley; Johan W De Fijter; Alexander Yussim; Marc Hazzan; Thomas Wekerle; David Berglund; Consuelo De Biase; María José Pérez-Sáez; Anja Mühlfeld; Giuseppe Orlando; Katia Clemente; Quirino Lai; Francesco Pisani; Aljosa Kandus; Marije Baas; Frederike Bemelman; Jadranka Buturovic Ponikvar; Hakim Mazouz; Piero Stratta; Jean-François Subra; Florence Villemain; Andries J Hoitsma; Laura Braun; Maria Carmen Cantarell; Hulya Colak; Aisling Courtney; Giovanni Maria Frasca; Matthew Howse; Maarten Naesens; Tomas Reischig; Daniel Serón; Nurhan Seyahi; Cem Tugmen; Angel Alonso Hernandez; Luboslav Beňa; Luigi Biancone; Vania Cuna; Carmen Díaz-Corte; Alexandre Dufay; André Gaasbeek; Arnaud Garnier; Philippe Gatault; Miguel Angel Gentil Govantes; François Glowacki; Oliver Gross; Bruno Hurault de Ligny; Uyen Huynh-Do; Bénédicte Janbon; Luis Antonio Jiménez Del Cerro; Frieder Keller; Gaetano La Manna; Ricardo Lauzurica; Hervé Le Monies De Sagazan; Friedrich Thaiss; Christophe Legendre; Séverine Martin; Marie-Christine Moal; Christian Noël; Evangeline Pillebout; Gian Benedetto Piredda; Ana Ramírez Puga; Wladyslaw Sulowicz; Serhan Tuglular; Michaela Prokopova; Mélanie Chesneau; Alain Le Moine; Pierrick Guérif; Jean-Paul Soulillou; Marc Abramowicz; Magali Giral; Judith Racapé; Umberto Maggiore; Sophie Brouard; Daniel Abramowicz

doi:10.1093/ndt/gfv437

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

Annick Massart, Annaïck Pallier, Julio Pascual, Ondrej Viklicky, Klemens Budde, Goce Spasovski, Marian Klinger, Mehmet Sukru Sever, Søren Schwartz Sørensen, Karine Hadaya, Rainer Oberbauer, Christopher Dudley, Johan W De Fijter, Alexander Yussim, Marc Hazzan, Thomas Wekerle, David Berglund, Consuelo De Biase, María José Pérez-Sáez, Anja MühlfeldGiuseppe Orlando, Katia Clemente, Quirino Lai, Francesco Pisani, Aljosa Kandus, Marije Baas, Frederike Bemelman, Jadranka Buturovic Ponikvar, Hakim Mazouz, Piero Stratta, Jean-François Subra, Florence Villemain, Andries J Hoitsma, Laura Braun, Maria Carmen Cantarell, Hulya Colak, Aisling Courtney, Giovanni Maria Frasca, Matthew Howse, Maarten Naesens, Tomas Reischig, Daniel Serón, Nurhan Seyahi, Cem Tugmen, Angel Alonso Hernandez, Luboslav Beňa, Luigi Biancone, Vania Cuna, Carmen Díaz-Corte, Alexandre Dufay, André Gaasbeek, Arnaud Garnier, Philippe Gatault, Miguel Angel Gentil Govantes, François Glowacki, Oliver Gross, Bruno Hurault de Ligny, Uyen Huynh-Do, Bénédicte Janbon, Luis Antonio Jiménez Del Cerro, Frieder Keller, Gaetano La Manna, Ricardo Lauzurica, Hervé Le Monies De Sagazan, Friedrich Thaiss, Christophe Legendre, Séverine Martin, Marie-Christine Moal, Christian Noël, Evangeline Pillebout, Gian Benedetto Piredda, Ana Ramírez Puga, Wladyslaw Sulowicz, Serhan Tuglular, Michaela Prokopova, Mélanie Chesneau, Alain Le Moine, Pierrick Guérif, Jean-Paul Soulillou, Marc Abramowicz, Magali Giral, Judith Racapé, Umberto Maggiore, Sophie Brouard, Daniel Abramowicz

Department of Clinical Medicine

31 Citations (Scopus)

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.

Original language	English
Journal	Nephrology, Dialysis, Transplantation
Volume	31
Issue number	6
Pages (from-to)	1002-13
Number of pages	12
ISSN	0931-0509
DOIs	https://doi.org/10.1093/ndt/gfv437
Publication status	Published - 24 Jun 2016

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Journal Article

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10.1093/ndt/gfv437

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Massart, A., Pallier, A., Pascual, J., Viklicky, O., Budde, K., Spasovski, G., Klinger, M., Sever, M. S., Sørensen, S. S., Hadaya, K., Oberbauer, R., Dudley, C., De Fijter, J. W., Yussim, A., Hazzan, M., Wekerle, T., Berglund, D., De Biase, C., Pérez-Sáez, M. J., ... Abramowicz, D. (2016). The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients. Nephrology, Dialysis, Transplantation, 31(6), 1002-13. https://doi.org/10.1093/ndt/gfv437

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients. / Massart, Annick; Pallier, Annaïck; Pascual, Julio et al.

In: Nephrology, Dialysis, Transplantation, Vol. 31, No. 6, 24.06.2016, p. 1002-13.

Research output: Contribution to journal › Journal article › Research › peer-review

Massart, A, Pallier, A, Pascual, J, Viklicky, O, Budde, K, Spasovski, G, Klinger, M, Sever, MS, Sørensen, SS, Hadaya, K, Oberbauer, R, Dudley, C, De Fijter, JW, Yussim, A, Hazzan, M, Wekerle, T, Berglund, D, De Biase, C, Pérez-Sáez, MJ, Mühlfeld, A, Orlando, G, Clemente, K, Lai, Q, Pisani, F, Kandus, A, Baas, M, Bemelman, F, Ponikvar, JB, Mazouz, H, Stratta, P, Subra, J-F, Villemain, F, Hoitsma, AJ, Braun, L, Cantarell, MC, Colak, H, Courtney, A, Frasca, GM, Howse, M, Naesens, M, Reischig, T, Serón, D, Seyahi, N, Tugmen, C, Alonso Hernandez, A, Beňa, L, Biancone, L, Cuna, V, Díaz-Corte, C, Dufay, A, Gaasbeek, A, Garnier, A, Gatault, P, Gentil Govantes, MA, Glowacki, F, Gross, O, Hurault de Ligny, B, Huynh-Do, U, Janbon, B, Jiménez Del Cerro, LA, Keller, F, La Manna, G, Lauzurica, R, Le Monies De Sagazan, H, Thaiss, F, Legendre, C, Martin, S, Moal, M-C, Noël, C, Pillebout, E, Piredda, GB, Puga, AR, Sulowicz, W, Tuglular, S, Prokopova, M, Chesneau, M, Le Moine, A, Guérif, P, Soulillou, J-P, Abramowicz, M, Giral, M, Racapé, J, Maggiore, U, Brouard, S & Abramowicz, D 2016, 'The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients', Nephrology, Dialysis, Transplantation, vol. 31, no. 6, pp. 1002-13. https://doi.org/10.1093/ndt/gfv437

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

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.",

keywords = "Journal Article",

author = "Annick Massart and Anna{\"i}ck Pallier and Julio Pascual and Ondrej Viklicky and Klemens Budde and Goce Spasovski and Marian Klinger and Sever, {Mehmet Sukru} and S{\o}rensen, {S{\o}ren Schwartz} and Karine Hadaya and Rainer Oberbauer and Christopher Dudley and {De Fijter}, {Johan W} and Alexander Yussim and Marc Hazzan and Thomas Wekerle and David Berglund and {De Biase}, Consuelo and P{\'e}rez-S{\'a}ez, {Mar{\'i}a Jos{\'e}} and Anja M{\"u}hlfeld and Giuseppe Orlando and Katia Clemente and Quirino Lai and Francesco Pisani and Aljosa Kandus and Marije Baas and Frederike Bemelman and Ponikvar, {Jadranka Buturovic} and Hakim Mazouz and Piero Stratta and Jean-Fran{\c c}ois Subra and Florence Villemain and Hoitsma, {Andries J} and Laura Braun and Cantarell, {Maria Carmen} and Hulya Colak and Aisling Courtney and Frasca, {Giovanni Maria} and Matthew Howse and Maarten Naesens and Tomas Reischig and Daniel Ser{\'o}n and Nurhan Seyahi and Cem Tugmen and {Alonso Hernandez}, Angel and Luboslav Be{\v n}a and Luigi Biancone and Vania Cuna and Carmen D{\'i}az-Corte and Alexandre Dufay and Andr{\'e} Gaasbeek and Arnaud Garnier and Philippe Gatault and {Gentil Govantes}, {Miguel Angel} and Fran{\c c}ois Glowacki and Oliver Gross and {Hurault de Ligny}, Bruno and Uyen Huynh-Do and B{\'e}n{\'e}dicte Janbon and {Jim{\'e}nez Del Cerro}, {Luis Antonio} and Frieder Keller and {La Manna}, Gaetano and Ricardo Lauzurica and {Le Monies De Sagazan}, Herv{\'e} and Friedrich Thaiss and Christophe Legendre and S{\'e}verine Martin and Marie-Christine Moal and Christian No{\"e}l and Evangeline Pillebout and Piredda, {Gian Benedetto} and Puga, {Ana Ram{\'i}rez} and Wladyslaw Sulowicz and Serhan Tuglular and Michaela Prokopova and M{\'e}lanie Chesneau and {Le Moine}, Alain and Pierrick Gu{\'e}rif and Jean-Paul Soulillou and Marc Abramowicz and Magali Giral and Judith Racap{\'e} and Umberto Maggiore and Sophie Brouard and Daniel Abramowicz",

year = "2016",

month = jun,

day = "24",

doi = "10.1093/ndt/gfv437",

language = "English",

volume = "31",

pages = "1002--13",

journal = "Nephrology, Dialysis, Transplantation",

issn = "0931-0509",

publisher = "Oxford University Press",

number = "6",

}

TY - JOUR

T1 - The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients

AU - Massart, Annick

AU - Pallier, Annaïck

AU - Pascual, Julio

AU - Viklicky, Ondrej

AU - Budde, Klemens

AU - Spasovski, Goce

AU - Klinger, Marian

AU - Sever, Mehmet Sukru

AU - Sørensen, Søren Schwartz

AU - Hadaya, Karine

AU - Oberbauer, Rainer

AU - Dudley, Christopher

AU - De Fijter, Johan W

AU - Yussim, Alexander

AU - Hazzan, Marc

AU - Wekerle, Thomas

AU - Berglund, David

AU - De Biase, Consuelo

AU - Pérez-Sáez, María José

AU - Mühlfeld, Anja

AU - Orlando, Giuseppe

AU - Clemente, Katia

AU - Lai, Quirino

AU - Pisani, Francesco

AU - Kandus, Aljosa

AU - Baas, Marije

AU - Bemelman, Frederike

AU - Ponikvar, Jadranka Buturovic

AU - Mazouz, Hakim

AU - Stratta, Piero

AU - Subra, Jean-François

AU - Villemain, Florence

AU - Hoitsma, Andries J

AU - Braun, Laura

AU - Cantarell, Maria Carmen

AU - Colak, Hulya

AU - Courtney, Aisling

AU - Frasca, Giovanni Maria

AU - Howse, Matthew

AU - Naesens, Maarten

AU - Reischig, Tomas

AU - Serón, Daniel

AU - Seyahi, Nurhan

AU - Tugmen, Cem

AU - Alonso Hernandez, Angel

AU - Beňa, Luboslav

AU - Biancone, Luigi

AU - Cuna, Vania

AU - Díaz-Corte, Carmen

AU - Dufay, Alexandre

AU - Gaasbeek, André

AU - Garnier, Arnaud

AU - Gatault, Philippe

AU - Gentil Govantes, Miguel Angel

AU - Glowacki, François

AU - Gross, Oliver

AU - Hurault de Ligny, Bruno

AU - Huynh-Do, Uyen

AU - Janbon, Bénédicte

AU - Jiménez Del Cerro, Luis Antonio

AU - Keller, Frieder

AU - La Manna, Gaetano

AU - Lauzurica, Ricardo

AU - Le Monies De Sagazan, Hervé

AU - Thaiss, Friedrich

AU - Legendre, Christophe

AU - Martin, Séverine

AU - Moal, Marie-Christine

AU - Noël, Christian

AU - Pillebout, Evangeline

AU - Piredda, Gian Benedetto

AU - Puga, Ana Ramírez

AU - Sulowicz, Wladyslaw

AU - Tuglular, Serhan

AU - Prokopova, Michaela

AU - Chesneau, Mélanie

AU - Le Moine, Alain

AU - Guérif, Pierrick

AU - Soulillou, Jean-Paul

AU - Abramowicz, Marc

AU - Giral, Magali

AU - Racapé, Judith

AU - Maggiore, Umberto

AU - Brouard, Sophie

AU - Abramowicz, Daniel

PY - 2016/6/24

Y1 - 2016/6/24

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1093/ndt/gfv437

DO - 10.1093/ndt/gfv437

M3 - Journal article

C2 - 26763669

SN - 0931-0509

VL - 31

SP - 1002

EP - 1013

JO - Nephrology, Dialysis, Transplantation

JF - Nephrology, Dialysis, Transplantation

IS - 6

ER -

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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