Recurrent and <i>de novo</i> glomerulonephritis following renal transplantation: higher rates of rejection and lower graft survival


Mirioglu Ş., Caliskan Y., Goksoy Y., Gulcicek S., Ozluk Y., Sarihan I., ...Daha Fazla

INTERNATIONAL UROLOGY AND NEPHROLOGY, sa.12, ss.2265-2272, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1007/s11255-017-1719-3
  • Dergi Adı: INTERNATIONAL UROLOGY AND NEPHROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.2265-2272
  • Anahtar Kelimeler: Renal transplantation, Graft survival, Graft rejection, Glomerulonephritis, HENOCH-SCHONLEIN PURPURA, IGA-NEPHROPATHY, RISK, PROTEINURIA, NEPHRITIS, DISEASE
  • İstanbul Üniversitesi Adresli: Evet

Özet

In this retrospective study with case-control design, we aimed to determine the clinical and pathological characteristics of post-transplant glomerulonephritis (GN), and their effects on transplant recipients. One hundred and twenty renal transplant recipients with biopsy-proven recurrent or de novo primary GN were compared with two matched control groups including 120 transplant recipients with nonrecurrent primary GN (nonrecurrent GN group) and 120 transplant recipients with non-GN etiology (non-GN group). Primary outcome was allograft loss, and secondary outcomes were biopsy-confirmed cellular or antibody-mediated rejection. In recurrent/de novo GN, nonrecurrent GN and non-GN groups, 54.2% (n = 65), 16.7% (n = 20) and 8.3% (n = 10) of patients reached primary outcome after a median follow-up of 96 (IQR: 56-149) months, respectively. Allograft loss was significantly higher in recurrent/de novo GN group compared to nonrecurrent GN and non-GN groups (p < 0.001). At 10 years, allograft loss rates in recurrent/de novo GN group were 54.2% for focal segmental glomerulosclerosis, 53.2% for membranoproliferative glomerulonephritis, and 33.4% for IgA nephropathy cases. Biopsy-confirmed rejection rate was significantly higher in the recurrent/de novo GN group (n = 25, 20.8%) compared to non-GN (n = 8, 6.7%) group (p = 0.001). Recurrent/de novo GN is associated with higher risk of rejection and worse allograft survival.