National study on natural history of renal allografts in sickle cell disease or trait.

The natural history of renal allograft in recipients who have sickle cell disease or trait has not been widely studied. This survey attempted to collect all the case histories known at present and to assess the relationship of sickle cell disease or trait to the natural history of renal allograft. A questionnaire was sent to 120 transplant centers in North America. 106 centers responded to the study, compliance rate being 88%. 88 centers reported not having any experience with such a case, whereas 18 centers transplanted 34 kidneys in 30 patients with this disease or trait. 9 of these had sickle cell disease and 21 had the trait. Graft survival at 1 year was 23 of 34, i.e., 67%. Mortality was 4 of 30, i.e., 13% in the first year. Sickle cell crisis was noted in 8 patients during the first year, 7 of whom had sickle cell disease. Thus, sickle cell crisis is very common in sickle cell transplant patients. From the points of view of patient survival and graft survival, recipients of kidneys who have the disease or the trait do just as well after transplant as the remaining patient population.