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. 2022 May 10;23(1):178.
doi: 10.1186/s12882-022-02802-x.

Recurrence of IgA nephropathy after kidney transplantation: experience from the Swiss transplant cohort study

Cédric Jäger #  1 , Susanne Stampf #  2 , Karen Molyneux  3 , Jonathan Barratt  3 , Déla Golshayan  4 , Karine Hadaya  5 , Uyen Huynh-Do  6 , Francoise-Isabelle Binet  7 , Thomas F Mueller  8 , Michael Koller #  2 , Min Jeong Kim #  9
Affiliations

Recurrence of IgA nephropathy after kidney transplantation: experience from the Swiss transplant cohort study

Cédric Jäger et al. BMC Nephrol. .

Abstract

Background: Recurrence of IgA nephropathy (IgAN) after kidney transplantation occurs in about 30% of patients. The relevance of recurrence for the long-term graft survival is expected to increase, since graft survival continues to improve.

Methods: In a nested study within the Swiss Transplant Cohort Study the incidence of IgAN recurrence, predictive factors, graft function and graft and patient survival were evaluated. Serum concentration of total IgA, total IgG, Gd-IgA1 and IgA-IgG immune complex were measured using ELISA-based immunologic assays.

Results: Between May 2008 and December 2016, 28 women and 133 men received their kidney allograft for end-stage kidney disease due to IgAN in Switzerland. Over a median follow-up time of 7 years after transplantation, 43 out of 161 patients (26.7%) developed an IgAN recurrence, of which six (13.9%) had an allograft failure afterwards and further four patients (9.3%) died. During the same follow-up period, 6 out of 118 patients (5%) each experienced allograft failure or died without prior IgAN recurrence. After 11 years the risk for IgAN recurrence was 27.7% (95%-CI: 20.6-35.3%). Renal function was similar in patients with and without recurrence up to 7 years after transplantation, but worsened thereafter in patients with recurrence (eGFR median (interquartile range) at 8 years: 49 ml/min/1.73m2 (29-68) vs. 60 ml/min/1.73m2 (38-78)). Serum concentration of total IgA, total IgG, Gd-IgA1 and IgA-IgG immune complex within the first year posttransplant showed no significant effect on the recurrence of IgAN. Younger recipients and women had a higher risk of recurrence, but the latter only in the short term.

Conclusions: Our study showed a recurrence risk of 28% at 11 years after transplantation, which is consistent with previous literature. However, the predictive value of known biomarkers, such as serum Gd-IgA1 and IgA-IgG IC, for IgAN recurrence could not be confirmed.

Keywords: IgA nephropathy; Kidney transplantation; Predictive markers; Recurrent glomerulonephritis; Transplant outcome.

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Conflict of interest statement

All authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Probability of IgAN recurrence and death or graft failure post-transplant in the study population. Abbreviations: TX – transplantation; IgAN – IgA nephropathy
Fig. 2
Fig. 2
Information on proteinuria and estimated GFR over follow-up time in 161 renal transplant recipients with IgA nephropathy as underlying disease leading to TX. Abbreviations: TX – transplantation; eGFR – estimated glomerular filtration rate. Proteinuria is presented as ratio of protein to creatinine on the log scale, numerical results are given on original scale.
Fig. 3
Fig. 3
Distribution of biomarker concentrations in renal transplant recipients with IgA nephropathy as underlying disease leading to TX. Abbreviations: TX – transplantation; IgAN – IgA nephropathy; OD – optical density
See this image and copyright information in PMC

References

    1. Ponticelli C, Glassock RJ. Posttransplant recurrence of primary glomerulonephritis. Clin J Am Soc Nephrol. 2010;5(12):2363–2372. doi: 10.2215/CJN.06720810. - DOI - PubMed
    1. Marinaki S, Lionaki S, Boletis JN. Glomerular disease recurrence in the renal allograft: a hurdle but not a barrier for successful kidney transplantation. Transplant Proc. 2013;45(1):3–9. doi: 10.1016/j.transproceed.2012.12.021. - DOI - PubMed
    1. Uffing A, Perez-Saez MJ, Jouve T, Bugnazet M, Malvezzi P, Muhsin SA, et al. Recurrence of IgA nephropathy after kidney transplantation in adults. Clin J Am Soc Nephrol. 2021;16(8):1247–1255. doi: 10.2215/CJN.00910121. - DOI - PMC - PubMed
    1. Floege J, Feehally J. Treatment of IgA nephropathy and Henoch-Schonlein nephritis. Nat Rev Nephrol. 2013;9(6):320–327. doi: 10.1038/nrneph.2013.59. - DOI - PubMed
    1. Moroni G, Longhi S, Quaglini S, Gallelli B, Banfi G, Montagnino G, et al. The long-term outcome of renal transplantation of IgA nephropathy and the impact of recurrence on graft survival. Nephrol Dial Transplant. 2013;28(5):1305–1314. doi: 10.1093/ndt/gfs472. - DOI - PubMed

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