Prolonged renal allograft survival without immunosuppressive therapy
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To the Editor,
A 47-year-old White man with a history of renal transplantation was seen in the Nephrology clinic for worsening renal function and proteinuria. He was born with a single kidney with anatomic abnormalities leading to frequent urinary tract infections and end-stage renal disease by age 16. At that time, he received a kidney transplant from a deceased donor, but the allograft failed in 6 years, apparently due to cyclosporine toxicity. At age 22, he received a living-related kidney transplant from his sister. There were 3 out of 6 HLA loci mismatches, one each for A, B and DR between the patient and his sister and he received induction therapy with anti-thymocyte globulin. 4 years later, he had allograft nephrectomy of the first transplant due to pain and shortly thereafter, he stopped taking all his immunosuppressive medications because he lost his insurance and could not afford them. He had no kidney-related issues or hospitalizations for the next 20 years, and 1 year...
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This article does not contain any studies with human participants or animals performed by any of the authors. IRB approval is not applicable for a letter/single case study.
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