The Clinical Differences Between First and Second Kidney Transplant in IgA Nephropathy: A Multicenter Retrospective Study.
1Division of Nephrology, Asan Medical Center, Seoul, Republic of Korea
2Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
4Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
5Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Meeting: 2016 American Transplant Congress
Abstract number: D239
Keywords: Glomerulonephritis, Kidney transplantation
Session Information
Date: Tuesday, June 14, 2016
Session Name: Poster Session D: Poster Session II: Kidney Complications-Other
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background
Recurrent IgA nephropathy (IgAN) after renal transplantation has been reported to range between 12% and 65%. However, few data are available on the second transplantation in recurrent IgAN. In addition, the patients who develop kidney failure twice in native and transplanted kidney due to IgAN may have different courses from others. It is not known that second transplantation could be recommended for this subgroup. Therefore, this study aim to build a bottom line data for the possibility of second transplantation in patients who lost first transplanted kidney due to recurrent IgAN.
Methods
Patients who received renal transplantation twice due to recurrent IgAN at four large academic hospitals in Korea between March 1985 and December 2013 were reviewed. They were followed up until October 2014. All patients were identified recurrent IgAN in the first graft biopsies. The clinical courses and outcomes were compared between first and second transplantation in these patients
Results
Twenty eight patients were enrolled in this study. The degree of human leukocyte antigen mismatch and donor type was not different between the first and second renal transplantation. First grafts were failed after 106.64±48.72 months (mean±S.D.). Following the second transplantation, recurrent IgAN was identified only in two patients during the follow-up of 61.61±47.23 months. In one patient, the second graft was lost due to chronic rejection without mesangial IgA deposit. After 5 years of follow-up, more patients had good renal function (serum creatinine levels<1.3 mg/dL) in the second graft (first vs. second, 7.14% vs. 71.43%). At the final follow-up, the serum creatinine level was 1.16 ± 0.33 mg/dL in the second graft except one patient.
Conclusions
Second transplantation in recurrent IgAN showed reasonably good long-term results. Therefore, clinicians might be able to suggest second transplantation as an option for patients who lost the first graft due to recurrent IgAN.
CITATION INFORMATION: Baek C, Lee J, Park J, Kim H, Kim Y, Huh W, Yang J, Han D, Park S.-K. The Clinical Differences Between First and Second Kidney Transplant in IgA Nephropathy: A Multicenter Retrospective Study. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Baek C, Lee J, Park J, Kim H, Kim Y, Huh W, Yang J, Han D, Park S-K. The Clinical Differences Between First and Second Kidney Transplant in IgA Nephropathy: A Multicenter Retrospective Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-clinical-differences-between-first-and-second-kidney-transplant-in-iga-nephropathy-a-multicenter-retrospective-study/. Accessed October 20, 2020.« Back to 2016 American Transplant Congress