The Outcomes of Second Transplantation in Recurrent IgA Nephropathy

C. Baek,¹ H. Kim,¹ W. Yang,¹ W. Huh,² Y. Kim,³ J. Yang,⁴ D. Han,⁵ S.-K. Park.¹

¹Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
²Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
³Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
⁴Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
⁵Department of Surgery, Asan Medical Center, Seoul, Republic of Korea.

Meeting: 2015 American Transplant Congress

Abstract number: A54

Keywords: Glomerulonephritis, Graft survival, Kidney, Retransplantation

Session Information

Session Name: Poster Session A: Delayed Function/Acute Injury/Outcomes/Glomerulonephritis

Session Type: Poster Session

Date: Saturday, May 2, 2015

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

Background

Recurrence of original glomerulonephritis is an important cause of graft loss. In some studies, histologic recurrence of IgA nephropathy (IgAN) occurs in 60% after 1st kidney transplantation. However, there is no evidence that we can persuade or dissuade second transplantation in patients with recurrent IgAN. In this study, we evaluated the outcomes of 2nd transplantation in patients who lost 1st graft due to recurrent IgAN.

Methods

We reviewed all patients who received 2nd transplantation because of graft loss associated with recurrent IgAN in four academic hospitals in Korea from March 1985 to December 2013. All patients were diagnosed with recurrent IgAN in the first graft biopsies. There were 30 patients, and we followed them until 1st October, 2014. We evaluated the outcomes of the 2nd transplantations compared to the outcomes of the 1st transplantations in the same patients.

Results

Twenty three patients (76.7%) were male, and mean age of patients at the time of 2nd transplantation was 44.40 ± 10.36 years old. First graft survival was 100.93 ± 51.13 months. In 8 cases, crescents were identified in graft biopsies. After 2nd transplantation, 8 patients (26.7%) experienced rejection and IgAN recurred in 2 patients (6.7%). However, only 1 patient lost second graft due to chronic rejection during mean follow up time of 65.20 ± 52.39 months. Graft survival was better in the 2nd transplantation (p<0.001 by Log-rank test). There is time gap between two transplantations and more patients used FK506 and mycophenolate mofetil in the 2nd transplantation than in the first transplantation (p<0.001). More potent immunosuppressants in the 2nd transplantation could affect the better outcomes. There were no variables to predict the recurrence of IgAN or graft survival in second grafts.

Conclusions

Second transplantation in recurrent IgAN showed good long-term results compared to the first transplantation. Therefore, we might recommend second transplantation to the patients who experienced graft loss due to recurrent IgAN.

To cite this abstract in AMA style:

Baek C, Kim H, Yang W, Huh W, Kim Y, Yang J, Han D, Park S-K. The Outcomes of Second Transplantation in Recurrent IgA Nephropathy [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-outcomes-of-second-transplantation-in-recurrent-iga-nephropathy/. Accessed November 21, 2024.

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