Outcome of renal transplantation in Alport's syndrome: a single-center experience

Transplant Proc. 2012 Jan;44(1):261-3. doi: 10.1016/j.transproceed.2011.11.035.

Abstract

Background: Anti-glomerular basement membrane (anti-GBM) nephritis post-renal transplantation (RTx) is known to cause graft loss in Alport's syndrome (AS). We evaluated the results of RTx in AS patients vis à vis patient and graft survivals, incidence of anti-GBM nephritis, and causes of graft failure.

Materials and methods: Between 1993 and 2009 we performed 31 RTx on AS patients (28 males and three females) of overall mean age of 22 ± 7.9 years from six deceased and 27 living donors. Two patients underwent second RTx.

Results: Over a follow-up of 1, 3, 5, and 10 years, the mean serum creatinines (mg/dL) were 1.51 ± 0.52, 1.59 ± 0.26, 1.61 ± 0.30, and 1.63 ± 0.32, respectively. Patient survivals at 1, 5, and 10 years were 89.71%, 81.32% and 81.32% with graft survival for all periods of 81.2%. Twenty-one percent experienced biopsy-proven acute rejection episodes. Graft failures were due to anti-GBM nephritis in 12.2% (n = 4), chronic allograft nephropathy in 3.2% (n = 1), and acute rejection or cyclosporine toxicity 3.2% (n = 1 each). The mean duration to graft loss was 4.9 ± 2.4 months.

Conclusion: Graft and patient survivals were acceptable among transplant recipients with AS despite the risk of anti-GBM nephritis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Anti-Glomerular Basement Membrane Disease / diagnosis
  • Anti-Glomerular Basement Membrane Disease / etiology
  • Anti-Glomerular Basement Membrane Disease / therapy
  • Biomarkers / blood
  • Biopsy
  • Creatinine / blood
  • Female
  • Graft Rejection / diagnosis
  • Graft Rejection / etiology
  • Graft Rejection / therapy
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / adverse effects
  • India
  • Kaplan-Meier Estimate
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / mortality
  • Living Donors
  • Male
  • Middle Aged
  • Nephritis, Hereditary / mortality
  • Nephritis, Hereditary / surgery*
  • Reoperation
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers
  • Immunosuppressive Agents
  • Creatinine