Clinical importance of the updated Oxford classification in allograft IgA nephropathy. Issue 10 (20th May 2019)

• Record Type: Journal Article
• Authors: Park, Sehoon; Go, Heounjeong; Baek, Chung Hee; Kim, Young Hoon; Kim, Yong Chul; Yang, Seung Hee; Lee, Jung Pyo; Min, Sang–il; Ha, Jongwon; Song, Eun Young; Kim, Yon Su; Park, Su‐Kil; Lee, Hajeong; Moon, Kyung Chul
• Is Part Of: American journal of transplantation. Volume 19:Issue 10(2019)
• Page Start: 2855
• Page End: 2864
• Publication Date: 2019-05-20
• Subjects: clinical research/practice -- glomerular biology and disease -- graft survival -- kidney (allograft) function/dysfunction -- kidney disease: immune/inflammatory -- kidney transplantation/nephrology -- pathology/histopathology -- recurrent disease; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.15400
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : With the recent update to the Oxford classification for allograft IgA nephropathy (IgAN), additional investigations on the clinical significance of the updated components are warranted. We performed a retrospective cohort study at two tertiary hospitals. Kidney transplant recipients diagnosed with allograft IgAN were included in the study after additional review by specialized pathologists. We applied the updated Oxford classification and determined the MEST‐C scores of the patients. The main study outcome was death‐censored graft failure within 10 years after the establishment of allograft IgAN diagnosis and was assessed using the Cox regression analysis. Three hundred thirty‐three allograft IgAN patients were reviewed: 100 patients with confirmed native IgAN and 233 patients with other, clinical, or unknown primary causes for end‐stage renal disease (ESRD). The updated Oxford classification for allograft IgAN demonstrated prognostic value for graft failure, and patients with multiple MEST‐C components had worse outcomes. M, E, S, and C were significantly associated with the prognosis of recurred IgAN and T was the only independent prognostic parameter for allograft IgAN without confirmed native IgAN. Therefore, we suggest reporting MEST‐C scores in allograft biopsies and careful interpretation of the results according to the primary cause of ESRD. Abstract : The updated Oxford classification for allograft IgAN has prognostic value for graft outcome and its meaning depends on the primary cause of end‐stage renal disease.