Impact of Induction Immunosuppression on the Recurrence of Primary IgA Nephropathy.
Department of Surgery, Samsung Medical Center, Seoul, Korea
Meeting: 2017 American Transplant Congress
Abstract number: B168
Keywords: Glomerulonephritis, Graft failure, Immunosuppression, Kidney
Session Information
Session Name: Poster Session B: Kidney Complications II
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Purpose
IgA nephropathy (IgAN) may recur after kidney transplantation (KT) and potentially jeopardize the survival of the graft. The object of this study was to analyze the impact of induction immunosuppression on the incidence of recurrent IgAN and identify predictive risk factors for IgAN recurrence.
Methods
We used data from the Samsung Medical Center to conduct a recurrence-free survival analysis of recipients of a first kidney transplant for IgAN who received a graft between 1995 and 2015. Kaplan-Meier and Cox regression analysis were used to sort the significant risk factors of recurrence. Two hundred twenty six recipients with biopsy-proven IgAN received a KT and 211 recipients were enrolled in this study. Among them, 30 cases of IgAN recurrence were observed. The recipients were categorized into four groups according to the induction immunosuppression: no induction (group 1, n=72), anti-CD25 (group 2, n=90), antithymocyte globulin (ATG, group 3, n=25), and ATG+anti-CD20 (group 4, n=24).
Results
Graft survival rate was lower in recipient with IgAN recurrence than those without recurrence. (p=0.001) The 5-year and 10-year cumulative IgAN recurrence rates were 90.6% and 80.7%. Recipients received ATG (group 3) showed significantly higher 5-year recurrence free graft survival rate (100%) than recipients received no induction (group 1, 92.8%) or anti-CD25 (group 2, 85.0%). (p=0.02, <0.001, respectively). However, no significant risk factors for IgAN recurrence were identified with multivariate Cox regression analysis.
Conclusion
Recipients received ATG as induction immunosuppression showed low IgAN recurrence rate. However, the risk for IgAN recurrence was not associated with any specific induction immunosuppression modality. These findings should be further evaluated with well-designed prospective studies regarding the role of induction immunosuppression in reducing recurrence of IgAN.
CITATION INFORMATION: Lee K, Cho C, Lee N, Kim K, Kim S, Lee J, Lee J, Park H, Park J, Kim S. Impact of Induction Immunosuppression on the Recurrence of Primary IgA Nephropathy. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lee K, Cho C, Lee N, Kim K, Kim S, Lee J, Lee J, Park H, Park J, Kim S. Impact of Induction Immunosuppression on the Recurrence of Primary IgA Nephropathy. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-induction-immunosuppression-on-the-recurrence-of-primary-iga-nephropathy/. Accessed May 12, 2025.« Back to 2017 American Transplant Congress