Rejection rates in kidney transplant patients with and without IgA nephropathy

Freese, P; Nordén, Gunnela; Olausson, Michael; Nyberg, Gudrun

doi:10.1093/ndt/12.11.2385

Cited by 8 publications

(3 citation statements)

References 1 publication

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“…Seventy patients had biopsy-verified IgA nephropathy and received first kidney transplants [11]. The outcome of transplantation in this group of patients in comparison with matched controls has been presented in detail [12]. All patients had undergone renal biopsy with enough material to establish the diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Morphologic High-Risk Factors in IgA Nephropathy

Freese

Nordén

Nyberg

1998

Nephron

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Aim: Morphologic risk factors for developing end-stage renal failure (ESRD) due to IgA nephropathy may be difficult to identify in populations where the course is benign in the vast majority. Ours is a high-risk population. Methods: Protocols of 67 biopsies from native kidneys of kidney transplant patients with IgA nephropathy were reevaluated with respect to the prevalence of certain structural findings. Time points for onset of symptoms, biopsy procedure, and ESRD were recorded. Results: Features seen with more than expected frequency were: extracapillary proliferation in 49%, cellular infiltrates in the interstitium in 89%, marked tubular atrophy in 54%, and IgA deposits in the peripheral capillary loops in 71%. With extracapillary proliferation the remaining time to ESRD was 3.5 ± 3.2 versus 7.0 ± 4.2 years without (p < 0.0004). With marked tubular atrophy the remaining time was 3.5 ± 2.7 and 8.2 ± 4.2 years without (p = 0.0002). Cellular infiltrates in the interstitium also signified shorter progression (p = 0.009). Except for the presence of IgA in the periphery, no finding by immune fluorescence was more frequent than expected or correlated with progression. Conclusion: Extracapillary proliferation, interstitial cellular infiltrates, marked tubular atrophy, and IgA deposits in the peripheral capillary loops indicate risk of progressive renal failure in IgA nephropathy, but other findings by immune fluorescence do not.

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Section: Methodsmentioning

confidence: 99%

Morphologic High-Risk Factors in IgA Nephropathy

Freese

Nordén

Nyberg

1998

Nephron

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“…However, despite the possibility of the detrimental effects of a recurrence, most authors agree that these patients fare well after transplantation, and it has even been suggested that recipients with IgA nephropathy may be immunologically privileged and have better graft survival than recipients with other renal diseases (4). This is, however, not a uniform finding and other studies that have formally compared graft survival in recipients with IgA nephropathy and other renal diseases have failed to demonstrate a survival advantage of IgA nephropathy patients (5)(6)(7)(8). The issue thus remains unsettled.…”

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confidence: 98%

Exclusive Characteristics of Graft Survival and Risk Factors in Recipients with Immunoglobulin A Nephropathy: A Retrospective Analysis of Registry Data

et al. 2005

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“…Ten‐year graft survivals were excellent regardless of the type of primary diseases. Freese et al 20 . and Bumgardner et al 10 .…”

Section: Discussionmentioning

confidence: 98%

Live donor renal transplantation in patients with end‐stage renal failure due to IgA nephropathy: clinicopathological assessment

Kim

Jeong²,

Kwon³

et al. 2002

Nephrology

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SUMMARY: The long‐term outcome was evaluated, in terms of recurrence and graft survival, after live donor renal transplantation in 90 grafts in 89 patients with biopsy‐proven IgA nephropathy (IgAN) as a primary diagnosis of end‐stage renal disease. Additionally, histological assessment including glomerular morphometry was performed in 19 grafts having recurrent IgAN. The 10‐year graft survival for IgAN patients was 66%, which was comparable with that of 84% for 107 reference recipients having other kinds of glomerulonephritis (GN) or 69% for 90 other recipients having non‐GN renal failure (P = 0.27). In 43 grafts, 54 event graft biopsies were performed, and mesangial IgA deposits were documented in 19 grafts. In eight grafts, lesions were accompanied by chronic rejection (CR). Ten‐year cumulative recurrence was 44%. In total, 10 grafts were lost: this was due to CR (n = 3) or acute rejection (n = 1) in 24 recurrence‐free recipients; CR (n = 2) or recurrence (n = 2) in 19 patients with recurrence; and patient death (n = 2) in 46 patients who did not have graft biopsy. No difference in 10‐year graft survival between the patients with and without recurrence (63%vs 74%; P = 0.98), or the proportion of related donors was found (68%vs 83%; P = 0.25). In the grafts with recurrence, renal histological damage was relatively mild and had no uniform pattern. The percentage of global and segmental sclerosis were 11.9% and 3.7%, respectively. Non‐sclerotic glomeruli were ischaemic or hypertrophied. Mesangium showed lysis or focal and mild expansion by matrix and cellular increase. Glomerular morphometry was performed in seven patients, in whom glomerular hypertrophy was found as demonstrated by increases of Bowman's and glomerular tuft areas (1.4 and 1.3 times the control, respectively) and concomitant decrease of total glomerular and mesangial cells per glomerular cross‐section (71.2% and 84.9% of the control, respectively). In conclusion, recurrence increased to 44% with longer follow up, but this did not limit the graft outcome. Recurrence was not affected by the types of live donor. Glomerular hypertrophy in the recurrent IgAN group suggests hyperfiltration.

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Rejection rates in kidney transplant patients with and without IgA nephropathy

Abstract: Rejection rates were not reduced in patients with IgA nephropathy and survival of grafts and patients not better than for matched controls.

Cited by 8 publications

References 1 publication

Morphologic High-Risk Factors in IgA Nephropathy

Morphologic High-Risk Factors in IgA Nephropathy

Exclusive Characteristics of Graft Survival and Risk Factors in Recipients with Immunoglobulin A Nephropathy: A Retrospective Analysis of Registry Data

Live donor renal transplantation in patients with end‐stage renal failure due to IgA nephropathy: clinicopathological assessment

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