Renal transplantation in patients with primary immunoglobulin A nephropathy

Choy, Bo Ying, Chan, Tak Mao, Lo, Sing Kai, Lo, Wai Kei and Lai, Kar Neng 2003, Renal transplantation in patients with primary immunoglobulin A nephropathy, Nephrology, dialysis, transplantation, vol. 18, no. 11, pp. 2399-2404.

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Title Renal transplantation in patients with primary immunoglobulin A nephropathy
Author(s) Choy, Bo Ying
Chan, Tak Mao
Lo, Sing Kai
Lo, Wai Kei
Lai, Kar Neng
Journal name Nephrology, dialysis, transplantation
Volume number 18
Issue number 11
Start page 2399
End page 2404
Publisher Oxford University Press
Place of publication Oxford, England
Publication date 2003
ISSN 0931-0509
Keyword(s) graft survival
IgA nephropathy
outcome
recurrence
renal transplantation
Summary Background. Opinions on the clinical course and outcome of renal transplantation in patients with primary immunoglobulin A nephropathy (IgAN) have been controversial.
Methods. We conducted a retrospective single-centre study on 542 kidney transplant recipients over the period 1984–2001. Long-term outcome and factors affecting recurrence in recipients with primary IgAN were analysed.
Results. Seventy-five patients (13.8%) had biopsy-proven IgAN as the cause of renal failure, and their mean duration of follow-up after transplantation was 100 ± 5.8 months. Fourteen (18.7%) of the 75 patients had biopsy-proven recurrent IgAN, diagnosed at 67.7 ± 11 months after transplantation. The risk of recurrence was not associated with HLA DR4 or B35. Graft failure occurred in five (35.7%) of the 14 patients: three due to IgAN and two due to chronic rejection. Three (4.9%) of the 61 patients without recurrent IgAN had graft failure, all due to chronic rejection. Graft survival was similar between living-related and cadaveric/living-unrelated patients (12-year graft survival, 88 and 72%, respectively, P = 0.616). Renal allograft survival within the first 12 years was better in patients with primary IgAN compared with those with other primary diseases (80 vs 51%, P = 0.001). Thereafter, IgAN patients showed an inferior graft survival (74 vs 97% in non-IgAN patients, P = 0.001).
Conclusions.
Our data suggested that around one-fifth of patients with primary IgAN developed recurrence by 5 years after transplantation. Recurrent IgA nephropathy in allografts runs an indolent course with favourable outcome in the first 12 years. However, the contribution of recurrent disease to graft loss becomes more significant on long-term follow up.
Language eng
Field of Research 110312 Nephrology and Urology
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2003, ERA–EDTA
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009356

Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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