Recurrence of Immunoglobulin A Nephropathy in Related Donor Kidney Transplant Recipients

M. Okumi,¹ D. Okada,¹ K. Unagami,² Y. Kakuta,¹ H. Shirakawa,³ T. Shimizu,⁴ K. Omoto,⁴ H. Ishida,¹ K. Tanabe.¹

¹Urology, Toyko Women's Medical University, Tokyo, Japan
²Nephrology, Toyko Women's Medical University, Tokyo, Japan
³Urology, Ohkubo Hospital, Tokyo, Japan
⁴Urology, Toda Chuo General Hospital, Saitama, Japan.

Meeting: 2018 American Transplant Congress

Abstract number: 105

Keywords: Kidney transplantation, Nephropathy

Session Information

Session Name: Concurrent Session: Kidney Complications: Disease Recurrence

Session Type: Concurrent Session

Date: Sunday, June 3, 2018

Session Time: 4:30pm-6:00pm

Presentation Time: 4:54pm-5:06pm

Location: Room Hall 4B

Background

Secondary to an increase in the graft survival rates in patients undergoing successful kidney transplantation, an increase in the occurrence of recurrent glomerulonephritis has been noted. Rates of immunoglobulin A nephropathy (IgAN) recurrence vary significantly across studies, and risk factors for recurrent IgAN in kidney transplant recipients (KTRs) remain controversial.

Methods

We investigated 10-year biopsy-proven recurrence rates and risk factors among 309 KTRs with IgAN between 1995 and 2015. The primary endpoint was recurrent IgAN. We compared clinical, and treatment-, as well as transplant-related outcomes between those with and without recurrent IgAN. Time-to-recurrence analysis was performed using the Kaplan-Meier method and the stepwise Cox model. KTRs with follow-up periods > 10 years underwent censoring of data at 10 years. The median follow-up duration was 8.3 (interquartile range 4.7–10.0) years.

Results

Of the 309 KTRs, 90 showed recurrent IgAN, and 10 were observed to be donor-transmitted (zero-hour biopsy). The 10-year recurrence rate was 37.3% (95% confidence interval [CI] 30.5–44.2%) and showed time-dependent recurrence. The risk of recurrent IgAN was most significantly associated with a related donor (hazard ratio 2.93, 95% CI 1.58–5.42, P < 0.001). The 10-year recurrence rates for IgAN adjusted with estimated glomerular filtration rate in related and unrelated donors were 43.5% and 19.0%, respectively. There were no statistically significant differences observed in terms of graft failure, biopsy-proven rejection, and kidney function. However, KTRs who demonstrated recurrence showed a higher incidence of tonsillectomy and steroid use.

Conclusions

Our results suggest that signs and symptoms of recurrent IgAN should be evaluated aggressively in KTRs undergoing related-donor transplantation. There is a need for further studies related to genetic and/or familial interactions in KTRs with IgAN and related donors.

CITATION INFORMATION: Okumi M., Okada D., Unagami K., Kakuta Y., Shirakawa H., Shimizu T., Omoto K., Ishida H., Tanabe K. Recurrence of Immunoglobulin A Nephropathy in Related Donor Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Okumi M, Okada D, Unagami K, Kakuta Y, Shirakawa H, Shimizu T, Omoto K, Ishida H, Tanabe K. Recurrence of Immunoglobulin A Nephropathy in Related Donor Kidney Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/recurrence-of-immunoglobulin-a-nephropathy-in-related-donor-kidney-transplant-recipients/. Accessed November 21, 2024.

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