Related Experiment Videos
Recurrence of membranous nephropathy after renal transplantation. Incidence and risk factors in 1614 patients
C Couchoud1, C Pouteil-Noble, S Colon
1Transplantation Unit, E. Herriot Hospital, Lyon, France.
Abstract:
The exact incidence of recurrence of membranous nephropathy (MN) after renal transplantation is not well documented because of the limited number of series involving a small number of patients. The aim of this study was to assess the incidence of MN recurrence in our population of renal transplant patients, to identify the risk factors associated with the recurrence, and to analyze the influence of the recurrence on graft and patient survival rates. The recurrence was defined as biopsy-proven MN on the renal graft in a patient whose original disease was MN. Among 1614 consecutive renal transplantations performed from January 1, 1980, to June 1, 1993, the incidence of recurrence was 26.3%, i.e., 5 recurrences out of 19 transplantations. We were unable to show pretransplant epidemiological, immunological, and therapeutic factors associated with recurrence. The HLA DR3 allele was present in 2 patients with recurrence (40%), compared with 3 patients without recurrence (21.4%). The early use of cyclosporine was not associated with a decreased prevalence of MN recurrence. Graft survival was not influenced by the recurrence. Three lymphomas were observed in the 19 transplanted patients with MN as causal nephropathy.
Insights
Membranous nephropathy (MN) recurrence after kidney transplantation occurs in 26.3% of cases. Recurrence did not impact graft survival, but three lymphomas were noted in patients with MN.
Area of Science:
- Nephrology
- Transplantation Immunology
Background:
- Membranous nephropathy (MN) recurrence post-renal transplantation is poorly documented.
- Limited data exists on risk factors and outcomes of MN recurrence.
Purpose of the Study:
- Assess MN recurrence incidence in renal transplant patients.
- Identify risk factors for MN recurrence.
- Analyze recurrence impact on graft and patient survival.
Main Methods:
- Retrospective analysis of 1614 renal transplantations (1980-1993).
- Defined recurrence as biopsy-proven MN in the graft.
- Evaluated pretransplant factors, HLA DR3, and cyclosporine use.
Main Results:
- MN recurrence incidence was 26.3% (5/19 cases).
- No significant pretransplant risk factors identified.
- HLA DR3 allele showed a trend towards association (40% vs 21.4%).
- Early cyclosporine use did not reduce recurrence.
- Graft survival was not affected by recurrence.
- Three lymphomas observed in MN patients.
Conclusions:
- MN recurrence is relatively common after kidney transplantation.
- Risk factors remain elusive, but HLA DR3 may play a role.
- Recurrence does not compromise graft survival.
- Lymphoma development is a concern in these patients.