title: Outcomes following Kidney transplantation in IgA nephropathy: a UNOS/OPTN analysis.
abstract: This study updates assessment of post-transplant outcomes in IgAN patients in the modern era of immunosuppression. Using UNOS/OPTN data, patients ≥18 yr of age with first kidney transplant (1/1/1999 to 12/31/2008) were analyzed. Multivariable Cox regression models and propensity score-based matching techniques were used to estimate hazard ratios (HRs) for death-censored allograft survival (DCGS) and patient survival in IgAN compared to non-IgAN. Results of multivariable regression were stratified by donor type (living vs. deceased). A total of 107, 747 recipients were included (4589 with IgAN and 103 158 with non-IgAN). Adjusted HR for DCGS showed no significant difference between IgAN and non-IgAN. IgAN had higher patient survival compared to non-IgAN (HR 0.54, 95% CI 0.47-0.62, p < 0.0001 for deceased donors; HR 0.42, 95% CI 0.33-0.54, p < 0.0001 for living donors). Propensity score-matched analysis was similar, with no significant difference in DCGS between matched groups and higher patient survival in IgAN patients compared to non-IgAN group (HR 0.54, 95% CI 0.47, 0.63; p-value <0.0001). IgAN patients with first kidney transplant have superior patient survival and similar graft survival compared to non-IgAN recipients. Results can be used in prognostication and informed decision-making about kidney transplantation in patients with IgAN.
authors.affiliation: Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Aditya
authors.initials: A
authors.lastname: Kadiyala
authors.affiliation: Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Anna T
authors.initials: AT
authors.lastname: Mathew
authors.affiliation: Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Mala
authors.initials: M
authors.lastname: Sachdeva
authors.affiliation: Biostatistics Unit, Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY, USA.|Department of Molecular Medicine and Department of Population Health, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Cristina P
authors.initials: CP
authors.lastname: Sison
authors.affiliation: Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Hitesh H
authors.initials: HH
authors.lastname: Shah
authors.affiliation: Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Fishbane
authors.affiliation: Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Kenar D
authors.initials: KD
authors.lastname: Jhaveri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000401:mortality / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: IgA nephropathy; epidemiology and outcomes; glomerular disease; transplantation