Renal transplantation in patients with IgA mesangial glomerulonephritis

Abstract

Most patients with IgA nephritis are suitable candidates for renal transplantation. In about 33% of patients the disease may recur after transplantation, although there are differences in the various series because of the different criteria for biopsy, the different length of follow-up and the different ethnicities. Living donation, genetic factors and time of progression of original disease have been found to be related with the risk of recurrence by some investigators, but these associations were not confirmed by other studies. The graft survival in patients with IgA nephritis is similar or even better than that observed with other renal diseases. The available data indicate that recurrence has a little impact on the 10-yr graft survival. However, a minority of patients may show a rapid progressive course after recurrence. Little information is available on the impact of recurrence in the very long term. There is no established treatment for preventing or treating the recurrence of IgA nephritis.

C1q deposition in the renal allograft: a report of 24 cases

“…The milder clinical and pathological features associated with C1q deposition in the allograft compared with the native kidney are possibly due to the disease detection at early stages by protocol biopsies, the therapeutic effects of the maintenance immunosuppression regimens administered to prevent graft rejection, and/or the hemodynamic effects of calcineurin inhibitors. In contrast to recurrent IgA nephropathy, 14 microscopic hematuria is a rare manifestation of C1q deposition, found in only 9% of our cases.…”

Recurrent or De Novo IgA Nephropathy with Crescent Formation after Renal Transplantation

“…[6][7][8] It has been reported that recurrent IgA nephropathy occurred more frequently in living, related recipients, and in one series, a recurrence rate of up to 83% was found. [14] In this study, we first reported 10 Chinese cases of recurrent or de novo IgA nephropathy with crescent formation from 10-66.7%, accounting for 0.1% of our patients with kidney transplantation, 4.12% of patients who diagnosed recurrent or de novo IgA nephropathy, [4] and 55.6% of allograft kidney with crescent formation.…”

“…It has been estimated that approximately 20-24.3% of Chinese, [4,5] as well as 50-60% of western renal transplant recipients, with IgA nephropathy as the cause of their original kidney disease will develop recurrent disease. [6,7] Clinically, the manifestation of recurrent IgA nephropathy is often associated with microscopic hematuria and intermittent proteinuria, a benign prognosis. [8] Though rare, patients with recurrent IgA nephropathy can present with rapidly progressive glomerulonephritis and subsequent graft loss, characterized by a various degree of crescent formation in histological examination.…”

Pathogénie de la maladie de Berger : implication des immunoglobulines A et de leurs récepteurs

“…Après transplantation rénale chez un patient atteint de néphropathie à IgA, les dépôts mésangiaux d'IgA se reconstituent dans le rein greffé dans environ un tiers des cas [6,7]. Inversement, les dépôts d'IgA d'un rein atteint de néphropathie à IgA disparaissent lorsqu'il est greffé à un individu souffrant d'une autre affection rénale [8].…”