Transplant Outcomes in Patients with Idiopathic Membranous Nephropathy. (27th February 2013)

• Record Type: Journal Article
• Authors: Kennedy, Claire; Traynor, Carol; O'Kelly, Patrick; Dorman, Anthony; Conlon, Peter J.
• Other Names: Amore Alessandro Academic Editor.
• Is Part Of: International journal of nephrology. Volume 2013(2013)
• Publication Date: 2013-02-27
• Subjects: Nephrology -- Periodicals; Nephrology; Kidney Diseases; Nephrology; Periodicals; Periodicals; Fulltext; Internet Resources; Electronic journals; 616.61
• DOI: 10.1155/2013/818537
• Languages: English
• ISSNs: 2090-214X

Abstract

Abstract : Background . The natural history of idiopathic membranous nephropathy and recurrent disease in transplants is variable. We performed a retrospective cohort study of renal transplant recipients with a primary diagnosis of idiopathic membranous nephropathy. We aimed to establish patterns of disease recurrence and to identify factors associated with disease recurrence. Methods . We accessed the Irish renal transplant database to identify patients with biopsy-proven idiopathic membranous nephropathy in receipt of a renal transplant between 1982 and 2010. A detailed medical chart review was performed in all cases, and a senior renal histopathologist reviewed all histology specimens. Results . The outcomes of 32 patients, in receipt of 36 grafts, are reported. There was a male preponderance (n = 29 ). Significant graft dysfunction, directly attributable to recurrent disease, was evident in 31% of cases at 10 years. There was no significant association between time on dialysis, HLA mismatch, occurrence of rejection, and the development of recurrent membranous disease. One patient was retransplanted twice; all three grafts were lost to aggressive recurrent membranous disease. Conclusions . It remains difficult to identify those that will develop recurrent membranous nephropathy. Almost one third of patients in this cohort developed clinically significant recurrent disease at 10 years.