*Purpose: In patients with IgA nephropathy as the cause of ESKD, IgA deposits can recur in the transplanted kidney. However,the incidence and clinical impact of these recurrent deposits are unclear. Furthermore, clinical predictors and response to therapy have not been validated since single-center cohorts are small, and large registries suffer from misclassification of disease and missing data.

*Methods: As part of The Post-Transplant Glomerular Disease (TANGO) project, we performed a multicenter, international, retrospective observational study to determine the incidence, predictors and treatment response of IgA nephropathy post-transplantation. More than 12,000 kidney transplant recipients were screened to identify patients with biopsy-proven, idiopathic IgA nephropathy, transplanted between 2005 and 2015 were retrospectively identified in 15 TANGO-study centers in Europe, North America and South America. We then collected baseline (time of transplant), immunosuppression and serial patient information until patient death, graft failure, or last available follow-up visit.

*Results: At present, 360 patients with IgA-nephropathy have been included, but inclusion and collection of data is ongoing. The majority of the cohort is male (56%). Median age at manifestation of IgA nephropathy is 34 [IQR: 26-45] years, with a median time to end-stage renal disease of 52 [IQR: 12-120] months. In patients with completed records, median time of follow up is 9.7 [5.7-11.5] years in which 20% [95%CI: 16-25] of patients experienced a recurrence of IgA nephropathy. Median time to recurrence was 3.1 [IQR: 1.0-5.9] years and most recurrences were diagnosed on a clinically indicated biopsy, while 25% of recurrences were found on protocol biopsies. Four percent of the total cohort lost their graft due to recurrent IgA-nephropathy.

*Conclusions: In this large, international, heterogenous and detailed cohort of patients with IgA nephropathy and a kidney transplant, IgA nephropathy recurred in 20% of patients, but graft failure occurred only in a minority of patients. Data collection will end in January 2020 and final analysis will be performed, including multivariable cox-regression to identify predictors of recurrence and treatment response.

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