Massart, AnnickPallier, AnnaïckPascual, JulioViklicky, OndrejBudde, KlemensSpasovski, GoceKlinger, MarianSever, Mehmet SukruSørensen, Søren SchwartzHadaya, KarineOberbauer, RainerDudley, ChristopherDe Fijter, Johan WYussim, AlexanderHazzan, MarcWekerle, ThomasBerglund, DavidDe Biase, ConsueloPérez-Sáez, María JoséMühlfeld, AnjaOrlando, GiuseppeClemente, KatiaLai, QuirinoPisani, FrancescoKandus, AljosaBaas, MarijeBemelman, FrederikePonikvar, Jadranka ButurovicMazouz, HakimStratta, PieroSubra, Jean-FrançoisVillemain, FlorenceHoitsma, AndriesBraun, LauraCantarell, Maria CarmenColak, HulyaCourtney, AislingFrasca, Giovanni MariaHowse, MatthewNaesens, MaartenReischig, TomasSerón, DanielSeyahi, NurhanTugmen, CemAlonso Hernandez, AngelBeňa, LuboslavBiancone, LuigiCuna, VaniaDíaz-Corte, CarmenDufay, AlexandreGaasbeek, AndréGarnier, ArnaudGatault, PhilippeGentil Govantes, Miguel AngelGlowacki, FrançoisGross, OliverHurault de Ligny, BrunoHuynh-Do, UyenJanbon, BénédicteJiménez Del Cerro, Luis AntonioKeller, FriederLa Manna, GaetanoLauzurica, RicardoLe Monies De Sagazan, HervéThaiss, FriedrichLegendre, ChristopheMartin, SéverineMoal, Marie-ChristineNoël, ChristianPillebout, EvangelinePiredda, Gian BenedettoPuga, Ana RamírezSulowicz, WladyslawTuglular, SerhanProkopova, MichaelaChesneau, MélanieLe Moine, AlainGuérif, PierrickSoulillou, Jean-PaulAbramowicz, MarcGiral, MagaliRacapé, JudithMaggiore, UmbertoBrouard, SophieAbramowicz, Daniel2023-01-252023-01-252016-01-12http://hdl.handle.net/10668/9729Kidney 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. 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 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. In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.enfrequencygraft survivalkidney transplantationminimally immunosuppressed patientsoperational toleranceAdultEuropeFemaleGraft RejectionGraft SurvivalHumansImmune ToleranceImmunosuppression TherapyIncidenceKidney TransplantationMaleSurveys and QuestionnairesSurvival RateTransplant RecipientsTransplantation, Homologousresearch article26763669open access10.1093/ndt/gfv4371460-2385https://academic.oup.com/ndt/article-pdf/31/6/1002/17172992/gfv437.pdf