BACKGROUND: IgA nephropathy is a common glomerulonephritis for which there is no effective cure. It may recur after renal transplantation and cause graft loss. AIMS: To determine the prevalence and predict recurrence of IgA disease in transplant recipients. METHODS: A retrospective analysis was performed of all renal allografts in patients with IgA disease attending a National Renal Unit between 1984 and 1995. An immunopathological grading system was devised to assess the severity of disease at initial presentation and each patient was assigned a simple severity index. RESULTS: A total of 42 patients with IgA disease received 44 renal allografts. Biopsies were performed in 21 of the 44 transplants. Recurrence was diagnosed in five grafts (24%) and recurred only in the 'moderate' and 'severe' IgA groups. Recurrence was associated with younger age, glomerular crescents on the original renal biopsy, better donor/recipient HLA matching and greater number of rejections. CONCLUSION: The prevalence of recurrent IgA disease following transplantation in an Irish population is less than that reported at other centres (24% versus 60%). The severity of the original disease and transplant factors may predict recurrence post-transplantation.
BACKGROUND: IgA nephropathy is a common glomerulonephritis for which there is no effective cure. It may recur after renal transplantation and cause graft loss. AIMS: To determine the prevalence and predict recurrence of IgA disease in transplant recipients. METHODS: A retrospective analysis was performed of all renal allografts in patients with IgA disease attending a National Renal Unit between 1984 and 1995. An immunopathological grading system was devised to assess the severity of disease at initial presentation and each patient was assigned a simple severity index. RESULTS: A total of 42 patients with IgA disease received 44 renal allografts. Biopsies were performed in 21 of the 44 transplants. Recurrence was diagnosed in five grafts (24%) and recurred only in the 'moderate' and 'severe' IgA groups. Recurrence was associated with younger age, glomerular crescents on the original renal biopsy, better donor/recipient HLA matching and greater number of rejections. CONCLUSION: The prevalence of recurrent IgA disease following transplantation in an Irish population is less than that reported at other centres (24% versus 60%). The severity of the original disease and transplant factors may predict recurrence post-transplantation.