Renal transplantation: outcomesRisk factors for graft loss in patients with recurrent IGA nephropathy after renal transplantation
Section snippets
Patients and tissue samples
Among 440 renal transplants performed between 1980 and 2001, 34 displayed biopsy-proven IgAN as the cause of end-stage renal failure. We performed a retrospective analysis of these 34 renal transplant recipients. The diagnosis of recurrent IgAN was based on immunofluorescence analysis of graft biopsy showed mesangial IgA deposits. The possibility of IgAN from the donor was excluded by the negative findings in an 1-hour biopsy. Graft loss was defined as the end-stage renal failure requiring
Results
Renal allograft biopsies were performed in 30 patients among 34 renal transplant recipients who had biopsy-proven IgAN as the course of their end-stage renal failure. Twenty-four patients had biopsy-confirmed recurrent transplant IgAN and 6 patients had no evidence of the disorder. Four patients among the 24 patients with recurrent transplant IgAN progressed to graft failure.
Fig 1 shows graft survival among patients with versus without recurrence. There was no significant difference in
Discussion
This study was based on a retrospective analysis of 34 patients who underwent renal transplantation because of biopsy-proven IgAN. Recurrent IgAN after transplantation is common, being reported in 13% to 60% of patients depending on the duration of follow-up and the biopsy policy of the respective transplant center.2 In the present study we found the recurrence rate to be ≥70% (24 of 34). This recurrence rate is higher than that in previous reports. Several studies have reported a higher risk
References (8)
- et al.
Kidney transplantation in patients with IgA mesangial glomerulonephritis
Kidney Int
(2001) - et al.
Outcomes in kidney transplantation
Semin Nephrol
(2003) - et al.
Recurrent IgA nephropathy in living related donor transplantationrecurrence or transmission of familial disease?
Am J Kidney Dis
(1988) - et al.
Recurrent immunoglobulin A nephropathy after renal transplantationa significant contributor to graft loss
Transplantation
(1997)
Cited by (19)
Interventions for decreasing the risk of recurrent IgA nephropathy: A systematic review and meta-analysis
2023, Transplant ImmunologyThe clinical course of IgA nephropathy after kidney transplantation and its management
2017, Transplantation ReviewsCitation Excerpt :In a retrospective analysis [75] of 48 KTx recipients, all of Chinese origin, with biopsy-proven IgAN as the cause of ESRD, 29% of the patients had biopsy-confirmed recurrent transplant IgAN, after a median follow-up of 52 months, which was associated with greater serum IgA levels. With respect to the correlation between living-related donation and risk of recurrence [53,60,74–77], Wang et al. reported a higher graft failure rate in the long term, with the use of allografts from living-related donors, in comparison with unrelated donors [78], although this observation was not confirmed by others [57,60]. However, it is important to remember that familial IgAN carries a markedly increased risk of ESRD [79] and even minor urinary findings in related donors should be clarified by renal biopsy [80].
IgA nephropathy in kidney allograft recipients - Therapeutic perspective
2006, Transplantation ProceedingsRecurrence of IgA nephropathy and Henoch-Schönlein purpura after kidney transplantation: Risk factors and graft survival
2005, Transplantation ProceedingsRisk factors for recurrent IgA nephropathy after renal transplantation: A meta-analysis
2023, Biomolecules and Biomedicine