The Dutch Transplantation in Vasculitis (DUTRAVAS) Study

Abstract

In this study in 110 Dutch patients, the recurrence rate of AAGN within 5 years after kidney transplantation appeared slightly higher than in previous reports. Moreover, recurrence of AAGN contributed independently to kidney allograft loss, emphasizing the importance of clinical vigilance, because early treatment might be critical to rescuing the allograft.

Improved survival with renal transplantation for end-stage renal disease due to granulomatosis with polyangiitis: data from the United States Renal Data System

“…Previous studies had reported good graft and patient survival in smaller cohorts of renal transplant recipients who had ESRD due to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). 341014…”

Case report: de novo ANCA-associated vasculitis after kidney transplantation treated with rituximab and plasma exchange

“…In the two reported cases of de novo AAV, treatment with steroid and cyclophosphamide or steroid alone led to graft loss after 5 years or significantly impaired graft function at 6 months respectively [ 5 , 6 ]. There are several retrospective case series on the management of disease relapses after transplantation, the largest comprising 13 patients [ 4 , 15 ]. While older reports more commonly quote the use of cyclophosphamide, we found thirteen cases that were treated with rituximab [ 15 – 21 ].…”

“…There are several retrospective case series on the management of disease relapses after transplantation, the largest comprising 13 patients [ 4 , 15 ]. While older reports more commonly quote the use of cyclophosphamide, we found thirteen cases that were treated with rituximab [ 15 – 21 ]. Twelve of these responded to rituximab-based therapy, although publication bias may exaggerate this apparent efficacy.…”

Evaluating a Living Donor With Rheumatoid Arthritis for a Recipient With End-Stage Renal Disease From Antineutrophil Cytoplasmic Antibodies Associated Vasculitis

“…One cohort study, in particular, demonstrated that patient and transplant survival was better in AAV compared to nondiabetic patients [45]. Various single and multi-center cohort studies have evaluated the outcomes of renal transplantation in patients with AAV [8,11,12,19,22,[46][47][48][49][50][51] and have shown that the rate of patient and transplant survival in AAV is equal and comparable to control nondiabetic patients. The five-year posttransplant patient survival ranges between 77% and 96%, and the five-year graft survival is between 60% and 100%.…”

“…For this reason, despite the recurring nature of this disease, renal transplantation should be offered once they are eligible for patients with ESKD secondary to AAV. At the same time, the literature detailing the recurrence of AAV among kidney allograft recipients is equally extensive and compelling [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”