title: Recurrence and graft loss after kidney transplantation for henoch-schonlein purpura nephritis: a multicenter analysis.
abstract: OBJECTIVE
  The actuarial risk at 5 years for clinical recurrence of Henoch-Schönlein purpura nephritis (HSPN) and graft loss caused by recurrence of -HSPN after renal transplantation was reported in 1994 to be as high as 35% and 11%, respectively. The aim of this study is to re-evaluate, in a large cohort of patients with a long-term follow-up, whether these rates have changed.
  
  
  METHODS
  Patients from six transplant centers in Belgium and France with strict diagnostic criteria of HSPN and a potential post transplant follow-up of ≥3 years were included.
  
  
  RESULTS
  Forty-three patients were included. Patient survival is excellent: 98%, 95%, and 95% at 5, 10, and 15 years, respectively. Overall graft survival rates were 84%, 66%, and 56% at 5, 10, and 15 years, respectively. Clinical recurrence in a first kidney transplant occurred in five patients. Three patients lost their first graft due to HSPN recurrence 19 to 96 months after transplantation, two of whom had systemic signs of the illness. Actuarial risk for clinical recurrence in a first graft is 2.5% and 11.5% at 5 and 10 years, respectively. Actuarial risk for graft loss caused by recurrence in a first graft is 2.5% and 7.5% at 5 and 10 years, respectively. Severity of the disease at presentation and type of immunosuppression after transplantation did not affect recurrence.
  
  
  CONCLUSIONS
  We found that recurrence rates of HSPN after transplantation are lower than previously reported. The actuarial risk of graft loss from recurrence in a first graft is 7.5% at 10 years.
authors: Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. nada.kanaan@uclouvain.be
authors: Nada
authors: N
authors: Kanaan
authors: Georges
authors: G
authors: Mourad
authors: Eric
authors: E
authors: Thervet
authors: Patrick
authors: P
authors: Peeters
authors: Maryvonne
authors: M
authors: Hourmant
authors: Yves
authors: Y
authors: Vanrenterghem
authors: Martine
authors: M
authors: De Meyer
authors: Michel
authors: M
authors: Mourad
authors: Céline
authors: C
authors: Maréchal
authors: Eric
authors: E
authors: Goffin
authors: Yves
authors: Y
authors: Pirson
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium; D002648:Child; D005260:Female; D005602:France; D005922:Glomerulonephritis, IGA / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D006084:Graft Rejection / Q000276:immunology* / Q000517:prevention & control; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000276:immunology / Q000401:mortality; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents