Development of a Recurrence Risk Score in IgA Nephropathy after Kidney Transplantation: Role of Recipient Age and HLA-B Mismatch

L. M. Rodas Marin¹, E. Ruiz², A. García³, M. Blasco¹, P. Ventura¹, E. de Soussa¹, O. Viñas⁴, F. Diekmann¹, L. Quintana¹

¹Nephrology and Renal Trasplantation, Hospital Clinic, Barcelona, Spain, ²Immunology, Hospital Clinic, Barcelona, Spain, ³Pathology, Hospital Clinic, Barcelona, Spain, ⁴Inmunology, Hospital Clinic, Barcelona, Spain

Meeting: 2019 American Transplant Congress

Abstract number: C77

Keywords: Age factors, Graft survival, HLA matching, Recurrence

Session Information

Session Name: Poster Session C: Kidney Complications: Late Graft Failure

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Recurrence of IgA nephropathy is an important and growing cause of kidney allograft dysfunction. The purpose of this observational retrospective study was to characterize clinical and histological factors associated with risk of recurrence of this chronic glomerular disease after renal transplantation

*Methods: A cohort of 90 patients with IgA nephropathy, transplanted in Hospital Clinic of Barcelona between 1992 and 2016. The risk associated with patients’ age at the time of transplant, 24-hour proteinuria, HLA matching, immunosuppressive therapy, previous replacement therapy, type of donor, panel-reactive antibodies, cold ischemia, HLA typing, serum galactose-deficient IgA1 levels and allograft histology parameters were evaluated. Chronic kidney disease (CKD) 4 and CKD 5 were used as renal outcomes

*Results: Out of 86 patients, 23 (28%) had recurrence IgA nephropathy. A total of 38 patients performed a living transplant and 69,7% of those had related donors. The age at the time of transplant was significantly different in patients with recurrence than in patients with no-recurrence (p=0,000, 95% 5,4-16,89), performing a Cox regression analysis the age less than 40 years was shown to be a risk of recurrence (p=0,001). A greater HLA B mismatch were related to a less frequency of recurrence of the disease. But there were no significant differences among the type of donor, and immunosuppression maintenance therapy. The frequency of graft lost was significant higher in patients with recurrence of IgAN (p=0,026). Renal function and proteinuria at the end of the follow-up period were significantly higher in the recurrent group of recipients (p=0,014) and( p=0,005) respectively and the risk of chronic kidney disease (CKD) 4 was significantly higher in recipients with biopsy proven recurrence of IgA Nephropathy (p=0,021)

*Conclusions: In this cohort, age less than 40 years old was an independent risk factor of recurrence of IgA nephropathy after renal transplantation. Conversely, HLA-B mismatch was a potential protective factor for recurrence of this glomerular disease. Recurrence of IgA Nephropathy was an independent risk factor for graft loss and for developing CKD 4. These findings emphasize the impact of IgA nephropathy in the allograft survival and highlight the importance of performing further prospective multi-centric studies aiming to search non-invasive biomarkers and new therapeutical targets to halt the progression of CKD in this group of recipients

To cite this abstract in AMA style:

Marin LMRodas, Ruiz E, García A, Blasco M, Ventura P, Soussa Ede, Viñas O, Diekmann F, Quintana L. Development of a Recurrence Risk Score in IgA Nephropathy after Kidney Transplantation: Role of Recipient Age and HLA-B Mismatch [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/development-of-a-recurrence-risk-score-in-iga-nephropathy-after-kidney-transplantation-role-of-recipient-age-and-hla-b-mismatch/. Accessed May 11, 2025.

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