TY - JOUR
T1 - Recurrence of iga nephropathy after kidney transplantation in adults
AU - Uffing, Audrey
AU - Pérez-Saéz, Maria José
AU - Jouve, Thomas
AU - Bugnazet, Mathilde
AU - Malvezzi, Paolo
AU - Muhsin, Saif A.
AU - Lafargue, Marie Camille
AU - Reindl-Schwaighofer, Roman
AU - Morlock, Alina
AU - Oberbauer, Rainer
AU - Buxeda, Anna
AU - Burballa, Carla
AU - Pascual, Julio
AU - Von Moos, Seraina
AU - Seeger, Harald
AU - La Manna, Gaetano
AU - Comai, Giorgia
AU - Bini, Claudia
AU - Russo, Luis Sanchez
AU - Farouk, Samira
AU - Nissaisorakarn, Pitchaphon
AU - Patel, Het
AU - Agrawal, Nikhil
AU - Mastroianni-Kirsztajn, Gianna
AU - Mansur, Juliana
AU - Tedesco-Silva, Hélio
AU - Venturaé, Carlucci Gualberto
AU - Agena, Fabiana
AU - David-Neto, Elias
AU - Akalin, Enver
AU - Alani, Omar
AU - Mazzali, Marilda
AU - Manfro, Roberto Ceratti
AU - Bauer, Andrea Carla
AU - Wang, Aileen X.
AU - Cheng, Xingxing S.
AU - Schold, Jesse D.
AU - Berger, Stefan P.
AU - Cravedi, Paolo
AU - Riella, Leonardo V.
N1 - Funding Information:
This work was conducted with support from Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102), and financial contributions from Harvard University and its affiliated academic health care centers. Thecontentissolelytheresponsibilityoftheauthorsanddoesnotnec-essarilyrepresenttheofficialviewsofHarvardCatalyst,HarvardUni-versity, and its affiliated academic health care centers, or the National Institutes of Health. This study was supported in part by the Harold and Ellen Danser Endowed/Distinguished Chair in Transplantation at Massachusetts General Hospital (Boston, MA, USA).
Funding Information:
A. Buxeda reports having a Rio Hortega contract CM19/00004, Instituto de Salud Carlos III ; Hospital del Mar. E. David Neto reports receiving research funding from AstraZeneca. A.C. Bauer reports serving on speakers bureau for AstraZeneca and reports other interests/relationships with Associac¸ão Brasileira de Transplantes de Orgãos, Sociedade Brasileira de Nefrologia, and Sociedade Brasileira de Diabetes. E. Akalin reports having consultancy agreements with, receiving honoraria from, and serving as a scientific advisor or member of CareDx and Immucor and reports receiving research funding from Angion, Astellas, CareDx, and the National Institutes of Health. G. Comai reports receiving honoraria from Astellas and Novartis. H. Seeger reports receiving honoraria from Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Menarini, Mun-dipharma, and Vifor and reports other interests/relationships with Innovative Medicines Initiative Transbioline (European Union). H. Silva reports consultancy agreements with Novartis and Pfizer; receiving research funding from Novartis, Pfizer, and Sanofi; receiving honoraria from and serving on speakers bureau for Novartis and Pfizer; serving as a scientific advisor or member of Transplantation. J.D. Schold reports consultancy agreements with Guidry and East, Novartis, Sanofi Corporation, and Transplant Management Group; reports receiving honoraria from Novartis and Sanofi Inc; and reports serving as a Data Safety Monitoring Board Member for Bristol Myers Squibb. J. Pascual reports receiving honoraria from Chiesi (sporadic as speaker) and Novartis (sporadic as speaker). L.V. Riella reports receiving research funding from Bristol-Meyers Squibb, CareDx, Natera, and Visterra and reports receiving honoraria from, and serving as a scientific advisor or member of, CareDx. N. Agrawal reports employment with and having an ownership interest in CareDx Inc. and reports serving as a scientific advisor or member of Biosurfaces Inc. and FreeFlow Medical Devices Inc. R.C. Manfro reports serving as a scientific advisor or member of Brazilian Society of Nephrology and Brazilian Society of Transplantation. R. Oberbauer reports receiving research funding from Chiesi, Fresenius, Novartis, Roche, and Sandoz; receiving honoraria from Chiesi, Neovii, Sandoz, and Teva; patents and inventions with Amgen (sold patent, no royalties); serving as a scientific advisor or member of Amgen, Astellas, Chiesi, and Novartis; receiving speaker honoraria from Amgen, Astellas, Chiesi, Fresenius, Novartis, and Sandoz; and other interests/relationships with Austrian Society of Nephrology, European Society of Nephrology, and European Society of Organ Transplantation. S. Berger reports having consultancy agreements with Novartis; reports receiving research funding from Chiesi and Novartis; reports receiving honoraria from Novartis; and reports serving on the Advisory Board for Novartis and the Supervisory Board for Dutch Transplant Foundation. S. Farouk reports serving on the Editorial Boards of American Journal of Kidney Diseases, Clinical Transplantation,and Journal of Nephrology. T. Jouve reports receiving research funding from Chiesi Pharmaceuticals. X.S. Cheng reports receiving honoraria from Clari-tyCo and Medscape Education and reports receiving research funding from American Heart Association and National Institutes of Health. All remaining authors have nothing to disclose.
Publisher Copyright:
© 2021 by the American Society of Nephrology.
PY - 2021/8
Y1 - 2021/8
N2 - Background and objectives In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small. Design, setting, participants, & measurementsWe performed a multicenter, international, retrospective study to determine the incidence, risk factors, and treatment response of recurrent IgA nephropathy after kidney transplantation. Data were collected from all consecutive patients with biopsy-proven IgA nephropathy transplanted between 2005 and 2015, across 16 “The Post-Transplant Glomerular Disease” study centers in Europe, North America, and South America. Results Out of 504 transplant recipients with IgA nephropathy, recurrent IgA deposits were identified by kidney biopsy in 82 patients; cumulative incidence of recurrence was 23% at 15 years (95% confidence interval, 14 to 34). Multivariable Cox regression revealed a higher risk for recurrence of IgA deposits in patients with a pre-emptive kidney transplant (hazard ratio, 3.45; 95% confidence interval, 1.31 to 9.17) and in patients with preformed donorspecific antibodies (hazardratio, 2.59; 95%confidence interval, 1.09 to 6.19).Afterkidneytransplantation,development of de novo donor-specific antibodies was associated with subsequent higher risk of recurrence of IgA nephropathy (hazard ratio, 6.65; 95% confidence interval, 3.33 to 13.27). Immunosuppressive regimen was not associated with recurrent IgA nephropathy in multivariable analysis, including steroid use. Graft loss was higher in patients with recurrence of IgA nephropathy compared with patients without (hazard ratio, 3.69; 95% confidence interval, 2.04 to 6.66), resulting in 32% (95% confidence interval, 50 to 82) graft loss at 8 years after diagnosis of recurrence. Conclusions In our international cohort, cumulative risk of IgA nephropathy recurrence increased after transplant and was associated with a 3.7-fold greater risk of graft loss.
AB - Background and objectives In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small. Design, setting, participants, & measurementsWe performed a multicenter, international, retrospective study to determine the incidence, risk factors, and treatment response of recurrent IgA nephropathy after kidney transplantation. Data were collected from all consecutive patients with biopsy-proven IgA nephropathy transplanted between 2005 and 2015, across 16 “The Post-Transplant Glomerular Disease” study centers in Europe, North America, and South America. Results Out of 504 transplant recipients with IgA nephropathy, recurrent IgA deposits were identified by kidney biopsy in 82 patients; cumulative incidence of recurrence was 23% at 15 years (95% confidence interval, 14 to 34). Multivariable Cox regression revealed a higher risk for recurrence of IgA deposits in patients with a pre-emptive kidney transplant (hazard ratio, 3.45; 95% confidence interval, 1.31 to 9.17) and in patients with preformed donorspecific antibodies (hazardratio, 2.59; 95%confidence interval, 1.09 to 6.19).Afterkidneytransplantation,development of de novo donor-specific antibodies was associated with subsequent higher risk of recurrence of IgA nephropathy (hazard ratio, 6.65; 95% confidence interval, 3.33 to 13.27). Immunosuppressive regimen was not associated with recurrent IgA nephropathy in multivariable analysis, including steroid use. Graft loss was higher in patients with recurrence of IgA nephropathy compared with patients without (hazard ratio, 3.69; 95% confidence interval, 2.04 to 6.66), resulting in 32% (95% confidence interval, 50 to 82) graft loss at 8 years after diagnosis of recurrence. Conclusions In our international cohort, cumulative risk of IgA nephropathy recurrence increased after transplant and was associated with a 3.7-fold greater risk of graft loss.
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U2 - 10.2215/CJN.00910121
DO - 10.2215/CJN.00910121
M3 - Article
C2 - 34362788
AN - SCOPUS:85114029157
SN - 1555-9041
VL - 16
SP - 1247
EP - 1255
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 8
ER -