Long-Term Kidney and Patient Survival after Deceased Donor Transplantation in Two Brothers with Alport Syndrome from the Same Donor

Alport syndrome is a hereditary disorder caused by a mutation in type IV collagen, leading to progressive kidney disease and eventual end- stage renal failure. Kidney transplantation represents the optimal therapeutic option, typically associated with excellent graft survival. We report a long-term outcome in two brothers with genetically confirmed Alport syndrome (COL4A5 mutation inherited from their mother, also on hemodialysis). Receiving kidneys from the same deceased donor with only one HLA mismatch. A standard immunosuppression therapy was administered, including Anti-Thymocyte Globulin (ATG) as an induction, followed by maintenance therapy (steroids, a calcineurin inhibitor, and mycophenolic acid). Graft function in both recipients was established immediately, with diuresis up to 8 L and normalized serum creatinine within the first 24 hours after transplantation. During 12 years of follow-up, graft function remained stable, with normal serum creatinine levels, no occurrence of proteinuria, and no development of anti-HLA antibodies. The younger brother developed gingival hyperplasia and steroid-induced diabetes as complications of the therapy. Both patients remain employed and have families.