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Renal outcome of kidney-transplantation in Korean recipients with ANCA-associated vasculitis

1, 2, 3, 4, 5, 6

  1. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
  2. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
  3. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
  4. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
  5. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
  6. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. sangwonlee@yuhs.ac

CER10742 Submission on line
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
We investigated renal outcome of kidney-transplantation in Korean recipients with biopsy-proven renal involvement of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in a single centre.
METHODS:
We reviewed the medical records of 144 Korean patients and included 3 female patients with microscopic polyangiitis (MPA) and one male patient with eosinophilic granulomatosis with polyangiitis (EGPA) in this study. We obtained clinical and laboratory data related to kidney-transplantation, analysed renal outcome of kidney-transplantation in 4 recipients with AAV and compared it with those of previous studies.
RESULTS:
The mean age at diagnosis was 37.8 years and that at kidney-transplantation was 40.8 years. Time-gap from AAV to ESRD ranged from 1 to 48 months and that from AAV to kidney-transplantation ranged from 2 to 95 months. All kidney-recipients with had been followed-up for two years or greater. At diagnosis, MPO-ANCA was detected in only MPA patients, while, at transplantation, MPA-ANCA was detected in 2 MPA patients and an EGPA patient. All patients have received tacrolimus and mycophenolate mofetil based on glucocorticoid after kidney-transplantation. Among 4 kidney-recipients with AAV, one MPA patient underwent renal re-biopsies three times due to renal function deterioration during the follow-up. Renal histology revealed T cell-mediated and antibody-mediated rejection rather than relapse of MPA. Neither relapse nor graft failure was observed in our study.
CONCLUSIONS:
Renal outcome of kidney-transplantation in recipients with AAV was good and kidney-transplantation is deserved to be recommend as a safe and effective therapeutic modality to AAV patients with ESRD.

PMID: 29185962 [PubMed]

Received: 09/08/2017 - Accepted : 10/10/2017 - In Press: 27/11/2017