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Titolo:
Recurrent IgA nephropathy in renal transplant allografts
Autore:
Wang, AYM; Lai, FM; Yu, AWY; Lam, PKW; Chow, KM; Choi, PCL; Lui, SF; Li, PKT;
Indirizzi:
Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China Chinese Univ Hong Kong, Prince Wales Hosp, Dept Anat & Cellular Pathol, Ctr Clin Trial & Epidemiol Res, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China Alici Ho Miu Ling Nethersole Hosp, Hong Kong, Hong Kong, Peoples R China Alici Ho Miu Ling Nethersole Hosp Hong Kong Hong Kong Peoples R China na
Titolo Testata:
AMERICAN JOURNAL OF KIDNEY DISEASES
fascicolo: 3, volume: 38, anno: 2001,
pagine: 588 - 596
SICI:
0272-6386(200109)38:3<588:RINIRT>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNOGLOBULIN-A NEPHROPATHY; GLOMERULONEPHRITIS; DISEASE; FAILURE;
Keywords:
immunoglobulin A (IgA) nephropathy; renal allograft; Chinese;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Li, PKT Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China R China
Citazione:
A.Y.M. Wang et al., "Recurrent IgA nephropathy in renal transplant allografts", AM J KIDNEY, 38(3), 2001, pp. 588-596

Abstract

Previous reports of renal transplantation for patients with underlying Immunoglobulin A (IgA) nephropathy suggested a recurrence rate greater than 50% for transplant IgA nephropathy. Initially regarded as a benign condition,more recent data showed that recurrent transplant IgA nephropathy may be asignificant contributor to graft loss. We performed a retrospective analysis in a single center of 48 kidney transplant recipients, all of Chinese origin, with biopsy-proven IgA nephropathy as the cause of end-stage renal failure to determine the recurrence rate of IgA nephropathy in the transplantallograft and subsequent clinical course in Chinese patients. Median duration of follow-up was 52 months (range, 18 to 155 months). Fourteen patients(29%) had biopsy-confirmed recurrent transplant IgA nephropathy after a median of 52 months (interquartile range, 23 to 82 months) posttransplantation. Recurrent transplant IgA nephropathy was associated with greater serum IgA levels (P = 0.01). The presence of HLA-A2 in transplant recipients (P = 0.002) appeared to protect them from developing recurrent IgA nephropathy in the transplant allograft. Twenty-nine percent of patients with recurrent transplant IgA nephropathy had progressive deterioration of graft function. The progressive graft dysfunction (GD) rate was greater in patients with atransplant from a living related donor (LRD; 21%) compared with those witha transplant from a cadaveric or living unrelated donor (URD; 3%; P = 0.062). Although the cumulative graft survival rate was 100% at 5 years for transplants from both LRDs and URDs, the 10-year graft survival rate was only 63% for a graft from an LRD versus 93% for a URD (log-rank test, P = 0.19). A review of other reported series of recurrent transplant IgA nephropathy also showed an apparently greater incidence of GD for a graft from an LRD (28%) compared with a URD (15%). Our data suggest that although recurrent transplant IgA nephropathy is highly prevalent among the Chinese population, the risk for disease recurrence is not particularly increased compared withother ethnic groups. The trend toward a greater risk for GD for living related compared with unrelated allografts in patients with IgA nephropathy needs to be confirmed with further prospective study. (C) 2001 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 18:43:10