title: Recurrent IgA Nephropathy After Kidney Transplantation.
abstract: BACKGROUND
  Immunoglobulin (Ig)A nephropathy is the most common primary glomerulonephritis worldwide, with a high recurrence rate after kidney transplantation. The aim of this study was to assess allograft survival, impact of recurrence on allograft function, and risk factors for post-transplant IgA recurrence.
  
  
  METHODS
  We identified 104 patients with IgA nephropathy who underwent kidney transplantation at our center between 1993 and 2014. Fourteen patients underwent more than one allograft.
  
  
  RESULTS
  IgA recurrence was documented in 23 (19%) allografts. Median time to recurrence was 6.75 years (interquartile range, 1.4-9.2 years). Twelve of the 23 recurrences were from living related donors (P = .07), and those with younger age at transplantation (37.7 ± 2.3 vs 44 ± 1.3, P = .05) were at higher risk of recurrence. Mean allograft survival was reduced in those with recurrence (6.5 ± 5.1 years) compared with those without recurrence (10.4 ± 7.5 years). At 6 years after transplant, allograft failure was documented in 52% of the recurrence group compared with 10% in the non-recurrence group (P = .002).
  
  
  CONCLUSIONS
  IgA recurrence after transplant is an important cause of allograft loss. Living related donors and younger age at transplantation are associated with high recurrence rate. Close monitoring and treatment of recurrence are crucial.
authors: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: S
authors: S
authors: Nijim
authors: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: V
authors: V
authors: Vujjini
authors: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: S
authors: S
authors: Alasfar
authors: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: X
authors: X
authors: Luo
authors: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: B
authors: B
authors: Orandi
authors: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: C
authors: C
authors: Delp
authors: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: N M
authors: NM
authors: Desai
authors: Department of Surgery, New York University, New York, New York.
authors: R A
authors: RA
authors: Montgomery
authors: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: B E
authors: BE
authors: Lonze
authors: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: nalachk1@jhmi.edu.
authors: N
authors: N
authors: Alachkar
mesh_terms: D000328:Adult; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors