Outcomes of renal transplantation in recipients with Wegener's granulomatosis

Abstract

Wegener's granulomatosis (WG) is the leading cause of rapidly progressive glomerulonephritis-induced end-stage renal disease (ESRD). In this study, we compared transplant outcomes between recipients with ESRD caused by WG to recipients with ESRD secondary to other causes. Using OPTN/UNOS data from 1996 to 2007, 919 recipients with WG were identified. Post-transplant outcomes included rates of delayed graft function, acute rejection within one-yr post-transplant, overall and death-censored graft survival, and patient survival and were compared between recipients with ESRD secondary to WG versus ESRD from other causes. Recipients with ESRD because of WG had superior unadjusted and adjusted rates of graft loss, patient death, and functional graft loss (adjusted hazard ratio [HR] 0.711, 0.631, and 0.625 respectively, p < 0.001). When we compared the WG cohort to a non-WG, non-diabetic population, the HR for graft loss was still significant, but patient death and death-censored graft loss were not. Subgroup analysis of recipients aged over 60 confirmed that WG recipients had better unadjusted outcomes. This study supports the notion that renal transplantation is an effective treatment option for patients with ESRD secondary to WG. They fare similarly, if not better, than other patients.