title: The clinical outcomes of second kidney transplantation in IgA nephropathy: a multicenter retrospective study.
abstract: BACKGROUND
  Recurrent IgA nephropathy (IgAN) after kidney transplantation (KT) has been reported to range between 12 and 65%. However, few data are available on second transplantation in recurrent IgAN. Therefore, this study aimed to build bottom-line data for the possibility of second transplantation in patients who lost first transplanted kidney due to recurrent IgAN.
  
  
  METHODS
  Patients who received KT twice due to recurrent IgAN at four large academic hospitals in Korea between March 1985 and December 2013 were reviewed. They were followed up until October 2014. All patients were identified as having recurrent IgAN in the first graft biopsies. The clinical outcomes of the second KT in these patients were compared with the first KT and with all cases of second KT (n = 169) performed at one center in the same period.
  
  
  RESULTS
  28 patients were enrolled in this study. First grafts failed after 106.64 ± 48.72 months (mean ± SD). Following the second transplantation, recurrent IgAN was identified in only 2 patients during the follow-up of 61.61 ± 47.23 months. In 1 patient, the second graft was lost due to chronic rejection without mesangial IgA deposit. The second KT showed comparable graft survival compared with the first KT and the overall second KT (p = 0.308 by log-rank test). At the final follow-up, the serum creatinine level was 1.16 ± 0.33 mg/dL in the second graft except in 1 patient.
  
  
  CONCLUSIONS
  Second KT in recurrent IgAN showed reasonably good long-term results. Therefore, clinicians might be able to suggest second transplantation as an option for patients who lost the first graft due to recurrent IgAN.
authors.forename: Chung Hee
authors.initials: CH
authors.lastname: Baek
authors.forename: Jae Geun
authors.initials: JG
authors.lastname: Lee
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Park
authors.forename: Hyosang
authors.initials: H
authors.lastname: Kim
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Yang
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.forename: Woo Seong
authors.initials: WS
authors.lastname: Huh
authors.forename: Jaeseok
authors.initials: J
authors.lastname: Yang
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.forename: Su-Kil
authors.initials: SK
authors.lastname: Park
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000601:surgery*; D006084:Graft Rejection / Q000453:epidemiology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies