The Dutch Transplantation in Vasculitis (DUTRAVAS) Study: Outcome of Renal Transplantation in Antineutrophil Cytoplasmic Antibody–associated Glomerulonephritis. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Göçeroğlu, Arda; Rahmattulla, Chinar; Berden, Annelies E.; Reinders, Marlies E. J.; Wolterbeek, Ron; Steenbergen, Eric J.; Hilbrands, Luuk B.; Noorlander, Iris; Berger, Stefan P.; Peutz-Kootstra, Carine J.; Christiaans, Maarten H. L.; van Dijk, Marcory C. R. F.; de Joode, Anoek A. E.; Goldschmeding, Roel; van Zuilen, Arjan D.; Harper, Lorraine; Little, Mark A.; Hagen, E. Christiaan; Bruijn, Jan A.; Bajema, Ingeborg M.
• Is Part Of: Transplantation. Volume 100:Issue 4(2016)
• Publication Date: 2016-04
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000910
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: Data on the outcome of renal transplantation in antineutrophil cytoplasmic antibody–associated glomerulonephritis (AAGN) patients are still limited. In particular, how disease recurrence in the renal allograft defines graft outcome is largely unknown. Therefore, we conducted a multicenter observational clinical and histopathological study to establish recurrence rate of AAGN in the allograft and the impact of recurrence on allograft survival. Methods: Using the nationwide Dutch Pathology Registry (PALGA), we retrospectively collected clinical and histopathological data of consecutive AAGN patients who had developed end-stage renal failure and received a kidney allograft in 1 of 6 Dutch university hospitals between 1984 and 2011. Transplant biopsies were scored using the Banff '09 classification. Renal disease recurrence was scored using the histopathological classification of AAGN. Results: The posttransplantation recurrence rate of AAGN was 2.8% per patient year, accumulating to recurrence in a total of 11 of 110 AAGN patients within the first 5 years after transplantation. Four of these 11 patients lost their graft, with 1-year and 5-year graft survival rates of 94.5% and 82.8%, respectively. By multivariate analysis, AAGN recurrence was independently associated with subsequent graft loss. Conclusions: 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. Abstract : In a multicenter clinical and histological Dutch study, the authors report a 2.8% per patient year recurrence rate of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis, which contributes independently to subsequent graft loss. Supplemental digital content is available in the text.