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Transplant Proc. 2019 Jun;51(5):1491-1495. doi: 10.1016/j.transproceed.2019.01.115. Epub 2019 Apr 19.

Impact of Induction Immunosuppression on the Recurrence of Primary IgA Nephropathy.

Author information

1
Department of Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
2
Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea.
3
Department of Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. Electronic address: jbparkmd@gmail.com.
4
Department of Pathology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.

Abstract

OBJECTIVE:

The objective of this study was to analyze the impact of induction immunosuppression on the incidence of recurrent IgA nephropathy (IgAN).

METHODS:

We conducted recurrence-free survival analysis of recipients of a first kidney transplant for IgAN who received a graft between 1995 and 2015. Kaplan-Meier and Cox regression analyses were used to sort the significant risk factors for recurrence. A total of 226 recipients with biopsy-proven IgAN received a kidney transplant, and 218 recipients were enrolled.

RESULTS:

Among the recipients, 29 cases of IgAN recurrence were observed. The recipients were categorized into 3 groups according to induction immunosuppression: no induction (group 1, n = 72), anti-CD25 (group 2, n = 86), and antithymocyte globulin (ATG, group 3, n = 60). The 5- and 10-year cumulative IgAN recurrence rates were 9.7% and 21.0%, respectively. Recipients receiving ATG (group 3) exhibited significantly higher 4- and 5-year recurrence-free graft survival rates (both 96.4%) than recipients who received anti-CD25 (group 2, both 85.1%, P = .03). However, the induction therapy used (ATG or basiliximab) was not the risk factor for IgAN recurrence.

CONCLUSIONS:

Therefore, we concluded that ATG induction seems to postpone IgAN recurrence. These findings should be evaluated with well-designed prospective studies.

[Indexed for MEDLINE]

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