Abstract
As the clinical outcomes improve in kidney transplantation, largely because of the prevention of loss due to acute rejection, the incidence of allograft loss due to recurrent glomerulonephritis have become more important. Actually recurrent glomerulonephritis is the third most common cause of graft failure, ranking only behind immunologic rejection and death with a functioning graft. Preventive and therapeutic treatment strategies are necessary for those patients at risk. Current newer immunosuppressive protocols over the past 10 years have not affected the rate of disease recurrence or graft loss. In a certain recurrent glomerulitis, for example membranous nephropathy, there is emerging evidence that rituximab may be efficacious; however, larger clinical trials are warranted.
References
1). Gaston RS. Current and evolving immunosuppressive regimens in kidney transplantation. Am J Kidney Dis. 2006; 47(4 Suppl 2):S3–21.
2). Briganti EM, Russ GR, McNeil JJ, Atkins RC, Chadban SJ. Risk of renal allograft loss from recurrent glomerulonephritis. N Engl J Med. 2002; 347:103–9.
3). Glassock RJ, Feldman D, Reynolds ES, Dammin GJ, Merrill JP. Human renal isografts: a clinical and pathologic analysis. Medicine (Baltimore). 1968; 47:411–54.
4). Hariharan S, Adams MB, Brennan DC, Davis CL, First MR, Johnson CP, et al. Recurrent and de novo glomerular disease after renal transplantation: a report from Renal Allograft Disease Registry (RADR). Transplantation. 1999; 68:635–41.
5). Gourishankar S, Leduc R, Connett J, Cecka JM, Cosio F, Fieberg A, et al. Pathological and clinical characterization of the ‘troubled transplant': data from the DeKAF study. Am J Transplant. 2010; 10:324–30.
6). Matas AJ. Recurrent disease after kidney transplantation – it is time to unite to address this problem! Am J Transplant. 2006; 6:2527–8.
7). Baer PC, Geiger H. Mesenchymal stem cell interactions with growth factors on kidney repair. Curr Opin Nephrol Hypertens. 2010; 19:1–6.
8). Mulay AV, van Walraven C, Knoll GA. Impact of immunosuppressive medication on the risk of renal allograft failure due to recurrent glomerulonephritis. Am J Transplant. 2009; 9:804–11.
9). Suzuki K, Honda K, Tanabe K, Toma H, Nihei H, Yamaguchi Y. Incidence of latent mesangial IgA deposition in renal allograft donors in Japan. Kidney Int. 2003; 63:2286–94.
10). Suzuki H, Fan R, Zhang Z, Brown R, Hall S, Julian BA, et al. Aberrantly glycosylated IgA1 in IgA nephropathy patients is recognized by IgG antibodies with restricted heterogeneity. J Clin Invest. 2009; 119:1668–77.
11). Mestecky J, Suzuki H, Yanagihara T, Moldoveanu Z, Tomana M, Matousovic K, et al. IgA nephropathy: current views of immune complex formation. Contrib Nephrol. 2007; 157:56–63.
12). Furness PN, Roberts IS, Briggs JD. Recurrent glomerular disease in transplants. Transplant Proc. 2002; 34:2422.
13). Ponticelli C, Traversi L, Banfi G. Renal transplantation in patients with IgA mesangial glomerulonephritis. Pediatr Transplant. 2004; 8:334–8.
14). Han SS, Huh W, Park SK, Ahn C, Han JS, Kim S, et al. Impact of recurrent disease and chronic allograft nephropathy on the longterm allograft outcome in patients with IgA nephropathy. Transpl Int. 2010; 23:169–75. Erratum in: Transpl Int 2010;23: 860.
15). Andresdottir MB, Haasnoot GW, Persijn GG, Claas FH. HLA-B8, DR3: a new risk factor for graft failure after renal transplantation in patients with underlying immunoglobulin A nephropathy. Clin Transplant. 2009; 23:660–5.
16). Choy BY, Chan TM, Lo SK, Lo WK, Lai KN. Renal transplantation in patients with primary immunoglobulin A nephropathy. Nephrol Dial Transplant. 2003; 18:2399–404.
17). Ng YS, Vathsala A, Chew ST, Chiang GS, Woo KT. Long term outcome of renal allografts in patients with immunoglobulin A nephropathy. Med J Malaysia. 2007; 62:109–13.
18). Mousson C, Charon-Barra C, Funes de la Vega M, Tanter Y, Justrabo E, Martin L, et al. Recurrence of IgA nephropathy with crescents in kidney transplants. Transplant Proc. 2007; 39:2595–6.
19). Berthoux F, El Deeb S, Mariat C, Diconne E, Laurent B, Thibaudin L. Antithymocyte globulin (ATG) induction therapy and disease recurrence in renal transplant recipients with primary IgA nephropathy. Transplantation. 2008; 85:1505–7.
20). Courtney AE, McNamee PT, Nelson WE, Maxwell AP. Does angiotensin blockade influence graft outcome in renal transplant recipients with IgA nephropathy? Nephrol Dial Transplant. 2006; 21:3550–4.
21). Hiremath S, Fergusson D, Doucette S, Mulay AV, Knoll GA. Renin angiotensin system blockade in kidney transplantation: a systematic review of the evidence. Am J Transplant. 2007; 7:2350–60.
22). Kennoki T, Ishida H, Yamaguchi Y, Tanabe K. Proteinu-ria-reducing effects of tonsillectomy alone in IgA nephropathy recurring after kidney transplantation. Transplantation. 2009; 88:935–41.
23). Ushigome H, Suzuki T, Fujiki M, Nobori S, Sakamoto S, Okamoto M, et al. Efficacy of tonsillectomy for patients with recurrence of IgA nephropathy after kidney transplantation. Clin Transplant. 2009; 23(Suppl 20):17–22.
24). Kowalewska J, Yuan S, Sustento-Reodica N, Nicosia RF, Smith KD, Davis CL, et al. IgA nephropathy with crescents in kidney transplant recipients. Am J Kidney Dis. 2005; 45:167–75.
25). Tang Z, Ji SM, Chen DR, Wen JQ, Chen JS, Liu ZH, et al. Recurrent or de novo IgA nephropathy with cres-cent formation after renal transplantation. Ren Fail. 2008; 30:611–6.
26). Cattran D. Management of membranous nephropathy: when and what for treatment. J Am Soc Nephrol. 2005; 16:1188–94.
27). Dabade TS, Grande JP, Norby SM, Fervenza FC, Cosio FG. Recurrent idiopathic membranous nephropathy after kidney transplantation: a surveillance biopsy study. Am J Transplant. 2008; 8:1318–22.
28). Sprangers B, Lefkowitz GI, Cohen SD, Stokes MB, Valeri A, Appel GB, et al. Beneficial effect of rituximab in the treatment of recurrent idiopathic membranous nephropathy after kidney transplantation. Clin J Am Soc Nephrol. 2010; 5:790–7.
29). Ivanyi B. A primer on recurrent and de novo glomerulonephritis in renal allografts. Nat Clin Pract Nephrol. 2008; 4:446–57.
30). Beck LH Jr, Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009; 361:11–21.
31). Stahl R, Hoxha E, Fechner K. PLA2R autoantibodies and recurrent membranous nephropathy after transplantation. N Engl J Med. 2010; 363:496–8.
32). Gallon L, Chhabra D. Anti-CD20 monoclonal antibody (rituximab) for the treatment of recurrent idiopathic membranous nephropathy in a renal transplant patient. Am J Transplant. 2006; 6:3017–21.
33). El-Zoghby ZM, Grande JP, Fraile MG, Norby SM, Fervenza FC, Cosio FG. Recurrent idiopathic membranous nephropathy: early diagnosis by protocol biopsies and treatment with anti-CD20 monoclonal antibodies. Am J Transplant. 2009; 9:2800–7.
34). Andresdottir MB, Assmann KJ, Koene RA, Wetzels JF. Immunohistological and ultrastructural differences between recurrent type I membranoproliferative glomerulonephritis and chronic transplant glomerulopathy. Am J Kidney Dis. 1998; 32:582–8.
35). Andresdottir MB, Assmann KJ, Hoitsma AJ, Koene RA, Wetzels JF. Recurrence of type I membranoproliferative glomerulonephritis after renal transplantation: analysis of the incidence, risk factors, and impact on graft survival. Transplantation. 1997; 63:1628–33.
36). Karakayali FY, Ozdemir H, Kivrakdal S, Colak T, Emiroğ lu R, Haberal M. Recurrent glomerular diseases after renal transplantation. Transplant Proc. 2006; 38:470–2.
37). O'Meara Y, Green A, Carmody M, Donohoe J, Campbell E, Browne O, et al. Recurrent glomerulonephritis in renal transplants: fourteen years' experience. Nephrol Dial Transplant. 1989; 4:730–4.
38). Vangelista A, Frascà GM, Martella D, Bonomini V. Glomerulonephritis in renal transplantation. Nephrol Dial Transplant. 1990; 5(Suppl 1):42–6.
39). Braun MC, Stablein DM, Hamiwka LA, Bell L, Bartosh SM, Strife CF. Recurrence of membranoproliferative glomerulonephritis type II in renal allografts: The North American Pediatric Renal Transplant Cooperative Study experience. J Am Soc Nephrol. 2005; 16:2225–33.
40). Little MA, Dupont P, Campbell E, Dorman A, Walshe JJ. Severity of primary MPGN, rather than MPGN type, determines renal survival and posttransplantation recurrence risk. Kidney Int. 2006; 69:504–11.
41). Lorenz EC, Sethi S, Leung N, Dispenzieri A, Fervenza FC, Cosio FG. Recurrent membranoproliferative glomerulonephritis after kidney transplantation. Kidney Int. 2010; 77:721–8.
42). Wenderfer SE, Swinford RD, Mauiyyedi S, Witte DP, Braun MC. Cytomegalovirus and recurrent idiopathic membranoproliferative glomerulonephritis type 1: cause or consequence? Transplantation. 2007; 83:523–4.
43). Lien YH, Scott K. Long-term cyclophosphamide treatment for recurrent type I membranoproliferative glomerulonephritis after transplantation. Am J Kidney Dis. 2000; 35:539–43.