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Live donor renal allograft in end-stage renal failure patients from immunoglobulin A nephropathy

Authors
 YU SEUN KIM  ;  JANG IL MOON  ;  HYEON JOO JEONG  ;  MYOUNG SOO KIM  ;  SOON IL KIM  ;  KYU HUN CHOI  ;  HO YUNG LEE  ;  DAE SUK HAN  ;  KIIL PARK 
Citation
 TRANSPLANTATION, Vol.71(2) : 233-238, 2001 
Journal Title
 TRANSPLANTATION 
ISSN
 0041-1337 
Issue Date
2001
MeSH
Adult ; Biopsy ; Glomerulonephritis, IGA/complications* ; Glomerulonephritis, IGA/pathology ; Glomerulonephritis, IGA/surgery* ; Graft Survival ; Humans ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/surgery* ; Liver Transplantation*/immunology ; Liver Transplantation*/pathology ; Living Donors* ; Male ; Middle Aged ; Recurrence
Abstract
BACKGROUND: The purpose of this study was to attempt to resolve two important issues, i.e. to determine (1) whether the course of recurrent immunoglobulin A nephropathy (IgAN) is benign, and (2) whether it is advisable to use a related donor. METHODS: We evaluated the long-term outcome, in terms of recurrence and graft survival, after live related or unrelated donor renal transplantation, and assessed the validity of the use of related donors in 90 grafts in 89 IgAN patients. RESULTS: Ten-year graft survival for IgAN patients was 66%, compared with 84% for 107 reference recipients who had other kinds of glomerulonephritis (GN), and with 69% in 90 other recipients who had non-GN renal failure (P=0.27). In 43 grafts, 54 event graft biopsies were performed, documenting the presence of mesangial IgA deposits in 19 of those grafts. In eight grafts, lesions were accompanied by chronic rejection (CR). Ten-year cumulative recurrence was 44%. Ten grafts were lost: by CR (n=3) or acute rejection (n=1) in 24 recurrence-free recipients, by CR (n=2) or recurrence (n=2) in 19 recurrent patients, and by patient death (n=2) in 46 patients devoid of graft biopsy. We found no difference in 10-year graft survival between the recurrent and recurrence-free patients (63% vs. 74%, P=0.98), or the proportion of related donors (68% vs. 83%, P=0.25). The presence or matching of HLA B12, B35, or DR4 did not affect the recurrence. CONCLUSIONS: Recurrence increased to 44% with longer follow-up, but this did not limit the graft outcome. Recurrence was not affected by the kind of live donor. We conclude that live related or unrelated kidneys should be offered to IgAN patients.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007890-200101270-00011&LSLINK=80&D=ovft
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142703
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