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Outcome of Renal Allograft in Patients With Henoch-Schonlein Nephritis: Single-Center Experience and Systematic Review

By Seung Seok Han, Hui-Kyoung Sun, Jung Pyo Lee, Jong Won Ha, Yon Su Kim and Sang Joon Kim


Background. Henoch-Schonlein nephritis (HSN) is a rare condition resulting in end-stage renal disease. Therefore, graft outcomes and recurrence rates after transplantation are not well studied. Also, the effect of donor type on graft outcome has not been evaluated thoroughly. Methods. The graft outcome and recurrence rate in 20 kidney recipients with HSN were compared with age-, sex-, and donor source-matched controls (control A, primary immunoglobulin A nephropathy; control B, other causes; 40 recipients per group). To assess the effect of donor type, we pooled our data with two previous cohort studies where donor type had been described in detail. Results. Overall graft survival rates were 87.7% at 10 years. The overall recurrence rate of HSN was 15.4% over 10 years. Graft survival and recurrence rates in the HSN group were similar to those of control A and control B. The pooled data showed a 29.4% incidence rate for recurrent HSN. Living related donor transplantation showed a trend of higher recurrence compared with recipients with nonrelated grafts, although it was marginally significant (P = 0.059). However, the graft survival rate in related-donor recipients was not inferior to that in the unrelated-donor recipients. Conclusions. Long-term graft survival and recurrence rates in kidney recipients with HSN were comparable to those of recipients with primary immunoglobulin A nephropathy. The type of donor did not significantly affect long-term graft survival.Moroni G, 2008, NEPHROL DIAL TRANSPL, V23, P3010, DOI 10.1093/ndt/gfn209Lee J, 2008, AM J TRANSPLANT, V8, P228, DOI 10.1111/j.1600-6143.2007.02022.xTrapani S, 2005, SEMIN ARTHRITIS RHEU, V35, P143, DOI 10.1016/j.semarthrit.2005.08.007Soler MJ, 2005, TRANSPLANT P, V37, P3705, DOI 10.1016/j.transproceed.2005.09.172Choy BY, 2003, NEPHROL DIAL TRANSPL, V18, P2399, DOI 10.1093/ndt/gfg373Briganti EM, 2002, NEW ENGL J MED, V347, P103Davin JC, 2001, KIDNEY INT, V59, P823Kim YS, 2001, TRANSPLANTATION, V71, P233Ohmacht C, 1997, TRANSPLANTATION, V64, P1493MEULDERS Q, 1994, TRANSPLANTATION, V58, P1179HASEGAWA A, 1989, TRANSPLANT P, V21, P2130BUNCHMAN TE, 1988, PEDIATR NEPHROL, V2, P393DAMICO G, 1987, Q J MED, V64, P709HABIB R, 1987, AM J KIDNEY DIS, V10, P198NAST CC, 1987, AM J KIDNEY DIS, V9, P39BACHMAN U, 1986, TRANSPLANTATION, V42, P511CAMERON JS, 1982, TRANSPLANTATION, V34, P237HAMBURGER J, 1978, ANNU REV MED, V29, P67BALIAH T, 1974, TRANSPLANTATION, V18, P343BARON H, 1972, ISRAEL J MED SCI, V8, P1702GLASSOCK RJ, 1968, MEDICINE, V47, P411

Topics: Donor, Recurrence, Henoch-Schonlein purpura, Henoch-Schonlein nephritis
Year: 2010
DOI identifier: 10.1097/TP.0b013e3181c9cc4a
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