The association of acute rejection vs recurrent glomerular disease with graft outcomes after kidney transplantation.

Abstract:

BACKGROUND:It has been shown that glomerulonephritis (GN) recurrence affects graft survival more than acute rejection. Thus, we assessed allograft survival after biopsy-confirmed diagnosis of acute rejection or recurrent GN in current era of immunosuppression. METHODS:Allograft survival following a biopsy diagnosis of acute rejection or recurrent GN was determined in adult kidney transplant recipients from 1994 to 2013. A total of 306 patients (35%) with IgA, 298 (35%) with FSGS, 177 (21%) with lupus nephritis, and 81 (9%) with membranous nephropathy were followed for a median of 6.3 years. RESULTS:Among the 862 transplant recipients with primary GN, allograft loss was similar following a biopsy diagnosis of acute rejection or recurrent glomerular disease (11.5 vs 14.2/100 person-years, P = .15). Differences in allograft survival emerged after 2.5 years following recurrent disease, with significantly higher graft failure in patients with FSGS, MN, or LN compared with IgA after recurrence of disease (16.7 vs 7.5/100 person-years, P = .05). The advantage in allograft survival for IgA patients did not achieve significance after acute rejection (P = .10 for IgA vs FSGS, MN, and LN). CONCLUSIONS:Allograft survival was similar after disease recurrence or acute rejection after kidney transplant in patients with ESRD due to GN.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Singh T,Astor BC,Zhong W,Mandelbrot DA,Maursetter L,Panzer SE

doi

10.1111/ctr.13738

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

e13738

issue

12

eissn

0902-0063

issn

1399-0012

journal_volume

33

pub_type

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