PMID- 37724404 OWN - NLM STAT- MEDLINE DCOM- 20230920 LR - 20240321 IS - 1672-7347 (Print) IS - 1672-7347 (Linking) VI - 48 IP - 7 DP - 2023 Jul 28 TI - Clinical outcomes for kidney transplantation in 81 adults with IgA nephropathy. PG - 1017-1025 LID - 1672-7347(2023)07-1017-09 [pii] LID - 10.11817/j.issn.1672-7347.2023.230079 [doi] AB - OBJECTIVES: Immunoglobulin A nephropathy (IgAN) is one of the most common types of kidney disease, and kidney transplantation is the most effective treatment for end-stage renal disease. This study aims to analyze the clinical curative effect of renal transplantation for adults with IgAN and to discuss the efficacy and safety of kidney transplantation for IgAN at the perioperative period and medium- and long-term follow-up. METHODS: This retrospective study included the clinical and follow-up data of 81 adult patients with IgAN who underwent kidney transplantation at the Second Xiangya Hospital, Central South University from January 2018 to January 2022. Of the 81 patients whose age at (34.1+/-9.9) years old, 47 (58.0%) were male. The body mass index was (20.8+/-3.2) kg/m(2), and the human leukocyte antigen (HLA) mismatch number was 3.5+/-1.2. The estimated glomerular filtration rate (eGFR) and daily 24-hour urine output for the recipients on the 1st, 5th, and 7th day after kidney transplantation and when they were discharged were analyzed. The recovery of the transplanted kidney and occurrence of complications were comprehensively evaluated. The eGFR, urinary protein, and occult blood were evaluated at the 6th, 12th, 24th, 36th, and 48th month and at the last follow-up. RESULTS: The follow-up time was (25.7+/-15.8) months. No primary non-function occurred in any patient during the perioperative period time. Fifty-one (63.0%) patients had immediate graft function recovery, and 16 (19.8%) patients had slow graft function recovery. Delayed recovery of graft function was observed in 14 (17.3%) patients. A total of 19 perioperative complications occurred, including 9 patients with acute rejection, 5 patients with urinary fistula, 1 thrombosis in both lower limbs, and 4 lymphatic fistula. The eGFR at 6th, 12th, 24th, 36th, and 48th month of follow-up were (65.3+/-22.9), (67.6+/-23.0), (64.3+/-21.8), (65.9+/-24.7), and (68.7+/-31.2) mL/(min.1.73 m(2)), respectively. The eGFR remained high during the medium- and long-term follow-ups. At the longest follow-up of 56 months, eGFR fluctuation was still mild, and the positive rate of urine protein and occult blood was low. IgAN recurred in 4 transplanted kidneys, accounting for 4.94% of the total patients, without severe renal insufficiency. Three patients had kidney dysfunction due to severe pneumonia, rejection, and stone in the transplanted kidney. The overall survival rate of the transplanted kidney was higher than 95%, and the survival rate of all patients was 100% till Januray 2022. CONCLUSIONS: Renal transplantation for adults with IgAN had a remarkable short-term effect. The recipients can be beneficial significantly to favorable midium- and long-term outcomes. IgAN recurrence is infrequent and rarely causes severe renal function damage. FAU - Tang, Zhouqi AU - Tang Z AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. tzq0510@csu.edu.cn. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. tzq0510@csu.edu.cn. FAU - Li, Tengfang AU - Li T AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. ltf120316@163.com. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. ltf120316@163.com. FAU - Feng, Chen AU - Feng C AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Peng, Longkai AU - Peng L AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Xie, Xubiao AU - Xie X AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Peng, Fenghua AU - Peng F AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Lan, Gongbin AU - Lan G AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Yu, Shaojie AU - Yu S AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Wang, Yu AU - Wang Y AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. FAU - Dai, Helong AU - Dai H AD - Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011. helong68888@csu.edu.cn. AD - Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011. helong68888@csu.edu.cn. AD - Clinical Immunology Center, Central South University, Changsha 410011, China. helong68888@csu.edu.cn. LA - eng LA - chi GR - 2021JJ10076/the Outstanding Youth Program of Natural Science Foundation of Hunan Province, China/ PT - Journal Article TT - 81例成人IgA肾病肾移植的临床疗效（英文）. PL - China TA - Zhong Nan Da Xue Xue Bao Yi Xue Ban JT - Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences JID - 101230586 SB - IM MH - Adult MH - Humans MH - Male MH - Young Adult MH - Female MH - *Kidney Transplantation MH - *Glomerulonephritis, IGA/surgery MH - Retrospective Studies MH - Kidney MH - *Kidney Failure, Chronic/surgery PMC - PMC10930041 OTO - NOTNLM OT - immunoglobulin A nephropathy OT - kidney transplantation OT - outcomes COIS- The authors declare that they have no conflicts of interest to disclose. EDAT- 2023/09/19 06:43 MHDA- 2023/09/20 06:42 PMCR- 2023/07/28 CRDT- 2023/09/19 04:22 PHST- 2023/09/20 06:42 [medline] PHST- 2023/09/19 06:43 [pubmed] PHST- 2023/09/19 04:22 [entrez] PHST- 2023/07/28 00:00 [pmc-release] AID - 1672-7347(2023)07-1017-09 [pii] AID - 1672-7347（2023）07-1017-09 [pii] AID - 10.11817/j.issn.1672-7347.2023.230079 [doi] PST - ppublish SO - Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jul 28;48(7):1017-1025. doi: 10.11817/j.issn.1672-7347.2023.230079.