RECURRENCE OF TYPE I MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS AFTER RENAL TRANSPLANTATION
- 1 June 1997
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 63 (11), 1628-1633
- https://doi.org/10.1097/00007890-199706150-00016
Abstract
The information in the medical literature on the incidence of recurrence of type I membranoproliferative glomerulonephritis (MPGN) after renal transplantation and its impact on graft survival is limited because most data are derived from case reports or from studies involving a small number of patients. We analyzed the data from our transplant center. Among 1097 adult patients receiving their first allograft between 1977 and 1994, we identified 32 patients with type I MPGN. A recurrence was detected in 9 of the 27 recipients of a first cadaveric graft (33%). The cumulative incidence reached 48% at 4 years after transplantation when patients with graft failure from other causes were censored. All patients with recurrent MPGN had clinically significant proteinuria (>1 g/24 hr) that was first observed at a median time of 20 months (range, 1.5-42 months) after transplantation. Graft survival was significantly worse in patients with recurrence as compared with patients without recurrence. Mean duration of graft survival after the diagnosis of recurrence was 40 months. We could not detect any clinical characteristics of patients or donors that were associated with recurrent disease. However, an increased risk of recurrence was observed in patients with the HLA haplotype B8DR3. Four patients received an HLA-identical graft from a living related donor. Recurrence occurred in three patients (75%), with ensuing graft loss in two. The only patient with a haploidentical living related graft did not have a recurrence. Five patients with a recurrence in the first graft received a second transplant. Recurrence was observed in four of these patients (80%). Type I MPGN recurred after renal transplantation in half of the patients. The incidence may be even higher in recipients of an identical living related donor graft and in patients receiving a second transplant after having experienced a recurrence in their first graft. Recurrence of type I MPGN has a detrimental effect on graft survival.Keywords
This publication has 19 references indexed in Scilit:
- RANDOMIZED, PROSPECTIVE TRIAL OF CYCLOSPORINE MONOTHERAPY VERSUS AZATHIOPRINE-PREDNISONE FROM THREE MONTHS AFTER RENAL TRANSPLANTATION1Transplantation, 1996
- Renal transplantation: recurrence of original disease with particular reference to primary glomerulonephritisNephrology Dialysis Transplantation, 1995
- Recurrent and De Novo Renal Disease After Kidney Transplantation With or Without Cyclosporine AAmerican Journal of Kidney Diseases, 1991
- Glomerulonephritis in Renal TransplantationNephrology Dialysis Transplantation, 1990
- Recurrent Glomerulonephritis in Renal Transplants: Fourteen Years' ExperienceNephrology Dialysis Transplantation, 1989
- CYCLOSPORIN TREATMENT WITH CONVERSION AFTER THREE MONTHS VERSUS CONVENTIONAL IMMUNOSUPPRESSION IN RENAL ALLOGRAFT RECIPIENTSThe Lancet, 1987
- Major-Histocompatibility-Complex Extended Haplotypes in Membranoproliferative GlomerulonephritisNew England Journal of Medicine, 1986
- Idiopathic mesangiocapillary glomerulonephritis: Comparison of types I and II in children and adults and long-term prognosisAmerican Journal Of Medicine, 1983
- GLOMERULONEPHRITIS IN RENAL TRANSPLANTSTransplantation, 1982
- Recurrence of membranoproliferative glomerulonephritis following kidney transplantationAmerican Journal Of Medicine, 1976