Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
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.
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.
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.
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 26, 2020.
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