Latent IgA deposition from donor kidneys does not affect transplant prognosis, irrespective of mesangial expansion

Clin Transplant. Nov-Dec 2013;27 Suppl 26:14-21. doi: 10.1111/ctr.12158.

Abstract

Introduction: Latent mesangial immunoglobulin A (IgA) deposition in the donated kidney has been investigated in the context of kidney transplantation. However, few studies have examined the impact of mesangial expansion accompanied with IgA deposition. Therefore, we investigated the effects of latent IgA deposition and mesangial expansion on transplant prognosis following living-donor kidney transplantation.

Methods: We retrospectively analyzed 68 consecutive adult living-donor kidney transplantations performed at Kagawa University Hospital. Biopsies were performed at pre-implantation and at one year after transplantation.

Results: Twenty kidneys exhibited latent IgA deposition in pre-implantation biopsies, including 14 with mesangial expansion. Latent IgA deposition was not associated with renal function or donor urinalysis after donation, irrespective of mesangial expansion. Latent IgA deposition was not significantly associated with graft survival rate, allograft function, abnormal urinalysis, or the recurrence of IgA nephropathy, irrespective of mesangial expansion. At one year after transplantation, IgA deposition had disappeared in 14/20 allografts. Estimated glomerular function rate >40 mL/min/1.73 m(2) was significantly associated with the disappearance of IgA deposition.

Conclusions: The present study showed that latent IgA deposition from the donor kidney, irrespective of mesangial expansion, does not affect transplant prognosis following living-donor kidney transplantation.

Keywords: IgA deposition; IgA nephropathy; kidney transplantation; living-donor; mesangial expansion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Glomerular Filtration Rate
  • Glomerular Mesangium / pathology*
  • Glomerulonephritis, IGA / etiology
  • Glomerulonephritis, IGA / pathology*
  • Glomerulonephritis, IGA / therapy
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome