The Dutch Transplantation in Vasculitis (DUTRAVAS) Study: Outcome of Renal Transplantation in Antineutrophil Cytoplasmic Antibody-associated Glomerulonephritis

Arda Goceroglu*, Chinar Rahmattulla, Annelies E. Berden, Marlies E. J. Reinders, Ron Wolterbeek, Eric J. Steenbergen, Luuk B. Hilbrands, Iris Noorlander, Stefan P. Berger, Carine J. Peutz-Kootstra, Maarten H. L. Christiaans, Marcory C. R. F. van Dijk, Anoek A. E. de Joode, Roel Goldschmeding, Arjan D. van Zuilen, Lorraine Harper, Mark A. Little, E. Christiaan Hagen, Jan A. Bruijn, Ingeborg M. Bajema

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    28 Citations (Scopus)
    41 Downloads (Pure)

    Abstract

    BACKGROUND: Data on the outcome of renal transplantation in antineutrophil cytoplasmic antibody-associated glomerulonephritis (AAGN) patients are still limited. In particular, how disease recurrence in the renal allograft defines graft outcome is largely unknown. Therefore, we conducted a multicenter observational clinical and histopathological study to establish recurrence rate of AAGN in the allograft and the impact of recurrence on allograft survival.

    METHODS: Using the nationwide Dutch Pathology Registry (PALGA), we retrospectively collected clinical and histopathological data of consecutive AAGN patients who had developed end-stage renal failure and received a kidney allograft in 1 of 6 Dutch university hospitals between 1984 and 2011. Transplant biopsies were scored using the Banff '09 classification. Renal disease recurrence was scored using the histopathological classification of AAGN.

    RESULTS: The posttransplantation recurrence rate of AAGN was 2.8% per patient year, accumulating to recurrence in a total of 11 of 110 AAGN patients within the first 5 years after transplantation. Four of these 11 patients lost their graft, with 1-year and 5-year graft survival rates of 94.5% and 82.8%, respectively. By multivariate analysis, AAGN recurrence was independently associated with subsequent graft loss.

    CONCLUSIONS: In this study in 110 Dutch patients, the recurrence rate of AAGN within 5 years after kidney transplantation appeared slightly higher than in previous reports. Moreover, recurrence of AAGN contributed independently to kidney allograft loss, emphasizing the importance of clinical vigilance, because early treatment might be critical to rescuing the allograft.

    Original languageEnglish
    Pages (from-to)916-924
    Number of pages9
    JournalTransplantation
    Volume100
    Issue number4
    DOIs
    Publication statusPublished - Apr-2016

    Keywords

    • Adolescent
    • Adult
    • Aged
    • Allografts
    • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
    • Biopsy
    • Female
    • Glomerulonephritis
    • Graft Survival
    • Hospitals, University
    • Humans
    • Kaplan-Meier Estimate
    • Kidney Transplantation
    • Male
    • Middle Aged
    • Multivariate Analysis
    • Netherlands
    • Predictive Value of Tests
    • Proportional Hazards Models
    • Recurrence
    • Registries
    • Retrospective Studies
    • Risk Factors
    • Time Factors
    • Treatment Outcome
    • Journal Article
    • Multicenter Study
    • Observational Study

    Cite this