Am J Transplant. 2019;19(1):145-155.
Glomerular crescents are associated with worse graft outcome in allograft IgA nephropathy.
제1저자 박세훈,백충희 · 교신저자 이하정
소속 (10)
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Chungbuk National University Hospital, Chungcheongbukdo, Korea.
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Department of Pathology, Seoul National University Hospital, Seoul, Korea.
Abstract
The prognosis of patients with allograft IgA nephropathy (IgAN) requires further investigation. We performed a bicenter retrospective cohort study on kidney transplant recipients diagnosed with IgAN in allograft biopsy. Recipients without allograft IgAN but with known IgAN before transplantation were included as the control group. We investigated the associations between clinicopathological characteristics, including allograft crescents, and the risk of death-censored graft failure. In total, 1256 IgAN patients in both pre- and posttransplant stages were included. Among them, 559 were diagnosed with allograft IgAN, which was a time-dependent risk factor for worse prognosis (adjusted hazard ratio = 5.009 [3.610-6.951]; P < .001) during a median of 8.1 years of follow-up. Of the patients with allograft IgAN, 88 (15.9%) had glomerular crescents, including 40 patients (7.2%) with >10% crescent formation in the total biopsied glomeruli. The presence of glomerular crescents in IgAN was associated with a worse graft prognosis, and the association was still valid with the C scores of the current Oxford classification. In conclusion, allograft IgAN is a time-dependent event and is associated with worse graft outcomes. The pathological characteristics of allograft, particularly the degree of glomerular crescent formation, may represent important risk factors for a poor prognosis.
© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.
Keywords
clinical research/practicegraft survivalkidney (allograft) function/dysfunctionkidney transplantation/nephrologypathology/histopathology
그 밖의 정보
- 출판 형태
- Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
- 저널
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · eISSN 1600-6143
- 전자 출판
- 2018-06-27
- MeSH
- Adult · Allografts · Biopsy · Female · Follow-Up Studies · Glomerulonephritis, IGA / mortality / pathology · Graft Survival* · Humans · Kaplan-Meier Estimate · Kidney / pathology · Kidney Failure, Chronic / complications / surgery · Kidney Glomerulus / pathology · Kidney Transplantation / adverse effects · Male · Middle Aged · Postoperative Period · Prognosis · Proportional Hazards Models · Recurrence · Republic of Korea · Retrospective Studies · Risk Factors · Transplantation, Homologous / adverse effects · Treatment Outcome
- 연구비
- Ministry of Health and Welfare of Korea HI15C2632 · Ministry of Science, ICT and Future Planning NRF-2015M3C9A2054342