Safak Mirioglu1, Yasar Caliskan2, Yagmur Goksoy1, Sibel Gulcicek3, Yasemin Ozluk4, Irem Sarihan1, Nurhan Seyahi3, Isin Kilicaslan4, Aydin Turkmen5, Mehmet Sukru Sever5. 1. Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 2. Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Capa, Fatih, 34093, Istanbul, Turkey. ykcaliskan@yahoo.com. 3. Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. 4. Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 5. Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Capa, Fatih, 34093, Istanbul, Turkey.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Recurrent/de novo GN is associated with higher risk of rejection and worse allograft survival.
PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Recurrent/de novo GN is associated with higher risk of rejection and worse allograft survival.
Authors: J R Von Visger; Y Gunay; K A Andreoni; U Y Bhatt; U S Nori; T E Pesavento; E A Elkhammas; H A Winters; T Nadasdy; N Singh Journal: Clin Transplant Date: 2014-06-24 Impact factor: 2.863
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Authors: M Haas; B Sis; L C Racusen; K Solez; D Glotz; R B Colvin; M C R Castro; D S R David; E David-Neto; S M Bagnasco; L C Cendales; L D Cornell; A J Demetris; C B Drachenberg; C F Farver; A B Farris; I W Gibson; E Kraus; H Liapis; A Loupy; V Nickeleit; P Randhawa; E R Rodriguez; D Rush; R N Smith; C D Tan; W D Wallace; M Mengel Journal: Am J Transplant Date: 2014-02 Impact factor: 8.086