PMID- 25340602
OWN - NLM
STAT- MEDLINE
DCOM- 20150817
LR  - 20150603
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 99
IP  - 6
DP  - 2015 Jun
TI  - Recurrent membranoproliferative glomerulonephritis type I after kidney 
      transplantation: a 17-year single-center experience.
PG  - 1172-7
LID - 10.1097/TP.0000000000000459 [doi]
AB  - BACKGROUND: Most previously published studies of patients with 
      membranoproliferative glomerulonephritis type I are small or have short follow-up 
      period. We report the outcome of a fairly large cohort of patients followed up 
      for nearly 10 years. METHODS: Retrospective cohort study. Graft survival, 
      recurrence rate and risk factors for recurrence were analyzed for 43 patients 
      transplanted between the years 1995 and 2012. RESULTS: At a mean overall 
      follow-up of 118 +/- 61 months (median, 127.8; range, 4.9-217), 12 patients lost 
      their graft (28%). Death-censored actuarial 15-year graft survival rate was 56%. 
      Membranoproliferative glomerulonephritis recurred in eight patients (19%) at a 
      median time of 15.4 months (range, 4.4-70 months). Recurrence led to graft loss 
      in seven patients (88%) within a median of 11.6 months (range, 1.3-54 months) 
      from diagnosis. Median graft survival was 30.5 months for recurrence (range, 
      7-86). Actuarial 15-year graft survival was 71% for nonrecurrent. The risk for 
      recurrence was higher for patients with human leukocyte antigen (HLA) B49 (odds 
      ratio, 16.9; 95% confidence interval, 1.1-246; P=0.038) and HLA DR4 (odds ratio, 
      15.9; 95% confidence interval, 1.07-237; P=0.044) alleles. A trend toward 
      increased risk was found with shorter duration of dialysis before 
      transplantation. Four of 16 (25%) living-related versus none of the 
      living-unrelated donors' recipients recurred. The HLA B49, acute tubular necrosis 
      after transplantation, previous transplantations, and Arab origin were all 
      associated with decreased graft and patient survival. CONCLUSION: Patients 
      without recurrence in the first years should expect an excellent graft survival. 
      Nonrelated living donors should be preferred. The HLA B49 and DR4 alleles may 
      increase the risk for recurrence.
FAU - Green, Hefziba
AU  - Green H
AD  - 1 Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, 
      Israel. 2 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3 
      Department of Transplantation, Rabin Medical Center, Petah-Tikva, Israel. 4 
      Department of Internal Medicine E, Rabin Medical Center, Petah-Tikva, Israel. 5 
      Department of Pathology, Rabin Medical Center, Petah-Tikva, Israel.
FAU - Rahamimov, Ruth
AU  - Rahamimov R
FAU - Rozen-Zvi, Benaya
AU  - Rozen-Zvi B
FAU - Pertzov, Barak
AU  - Pertzov B
FAU - Tobar, Ana
AU  - Tobar A
FAU - Lichtenberg, Shelly
AU  - Lichtenberg S
FAU - Gafter, Uzi
AU  - Gafter U
FAU - Mor, Eytan
AU  - Mor E
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-B*49 antigen)
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Female
MH  - Glomerulonephritis, Membranoproliferative/*etiology/immunology
MH  - Graft Rejection/etiology/immunology
MH  - Graft Survival/immunology
MH  - HLA Antigens/genetics
MH  - HLA-B Antigens/genetics
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Young Adult
EDAT- 2014/10/24 06:00
MHDA- 2015/08/19 06:00
CRDT- 2014/10/24 06:00
PHST- 2014/10/24 06:00 [entrez]
PHST- 2014/10/24 06:00 [pubmed]
PHST- 2015/08/19 06:00 [medline]
AID - 10.1097/TP.0000000000000459 [doi]
PST - ppublish
SO  - Transplantation. 2015 Jun;99(6):1172-7. doi: 10.1097/TP.0000000000000459.