title: Association between post-transplantation immunoglobulin A deposition and reduced allograft function.
abstract: BACKGROUND
  Post-transplantation de novo and recurrent immunoglobulin A (IgA) deposition (IgAD) in the allograft is commonly observed. However, the association between post-transplantation IgAD and reduced allograft function has not been determined. We therefore investigated the association between reduced allograft function and post-transplantation IgAD using serial allograft biopsies.
  
  
  METHODS
  IgAD was retrospectively analyzed in 45 adults who underwent kidney transplantation for chronic glomerulonephritis, including IgA nephropathy, at Kagawa University Hospital. Allograft biopsy samples were obtained from per protocol biopsies obtained 1 and 3 years after transplantation, as well as from episode biopsies. Factors contributing to post-transplantation IgAD were assessed by calculating adjusted odds ratios (AORs) using logistic regression analysis.
  
  
  RESULTS
  Of the 45 recipients, 18 had post-transplantation allograft IgAD. The estimated glomerular filtration rates (eGFR) 1, 2, and 3 years after transplantation were lower in the recipients with than without IgAD. Urinalysis was normal in 61% of recipients with IgAD. Reduced allograft function (eGFR <40 mL/min/1.73 m(2)) 1 year after transplantation was significantly associated with post-transplantation IgAD (AOR = 34.4 [95% CI = 2.35-502], P = .01). Conversely, blood concentrations of mycophenolic acid and latent IgAD from donor kidneys were not significantly associated with post-transplantation IgAD.
  
  
  CONCLUSIONS
  Reduced allograft function may be associated with post-transplantation IgAD in the allograft.
authors.affiliation: Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan. Electronic address: sofue@med.kagawa-u.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Sofue
authors.affiliation: Department of Urology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Chiba, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Inui
authors.affiliation: Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hara
authors.affiliation: Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Moritoki
authors.affiliation: Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nishijima
authors.affiliation: Department of Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kushida
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nishiyama
authors.affiliation: Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kakehi
authors.affiliation: Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000328:Adult; D064591:Allografts / Q000473:pathology*; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D005920:Glomerular Mesangium / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007070:Immunoglobulin A; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007070:Immunoglobulin A