title: Renal transplantation in adults with Henoch-Schonlein purpura: long-term outcome.
abstract: BACKGROUND
  Little information is available about the long-term outcome of renal transplantation in adults with Henoch-Schonlein purpura (HSP).
  
  
  METHODS
  We compared the outcomes of 17 patients with HSP who received 19 renal transplants with those of 38 controls matched for time of transplantation, age, gender and source of donor. The mean post-transplant follow-up was 109 +/- 99 months for HSP patients and 110 +/- 78 months for controls.
  
  
  RESULTS
  The actuarial 15-year patient survival was 80% in HSP patients and 82% in controls, and the death-censored graft survival was 64% in HSP patients and in controls. The risks of acute rejection, chronic graft dysfunction, arterial hypertension and infection were not different between the two groups. In eight grafts (42%) recurrence of HSP nephritis was found (0.05/patient/year). In spite of therapy, one patient died and four eventually restarted dialysis respectively 10, 32, 35 and 143 months after renal transplant. Seventy-one percent of grafts transplanted in patients with necrotizing/crescentic glomerulonephritis of the native kidney had HSP recurrence in comparison to 12% of recurrences in patients with mesangial nephritis (P = 0.05)
  
  
  CONCLUSIONS
  Long-term patient and allograft survival of HSP patients was good. However, 42% of HSP patients, particularly those with necrotizing/crescentic glomerulonephritis of the native kidneys, developed a recurrence of HSP nephritis that eventually caused the loss of the graft function in half of them.
authors.affiliation: Divisione di Nefrologia e Dialisi-Padiglione Croff, Ospedale Maggiore IRCCS, Via della Commenda 15-20122 Milano, Italy. gmoroni@policlinico.mi.it
authors.forename: Gabriella
authors.initials: G
authors.lastname: Moroni
authors.forename: Beniamina
authors.initials: B
authors.lastname: Gallelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Diana
authors.forename: Alessia
authors.initials: A
authors.lastname: Carminati
authors.forename: Giovanni
authors.initials: G
authors.lastname: Banfi
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montagnino
authors.forename: Antonio
authors.initials: A
authors.lastname: Tarantino
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult