@article{3056270,
    title = "Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression",
    author = "Lionaki, S. and Makropoulos, I. and Panagiotellis, K. and Vlachopanos, G. and Gavalas, I. and Marinaki, S. and Liapis, G. and Michelakis, I. and Bokos, I. and Boletis, I.",
    journal = "PLOS ONE",
    year = "2021",
    volume = "16",
    number = "8 August",
    publisher = "Public Library of Science",
    doi = "10.1371/journal.pone.0253337",
    keywords = "calcineurin inhibitor;  cyclosporine;  HLA A antigen;  HLA B antigen;  HLA C antigen;  HLA DQB1 antigen;  HLA DRB1 antigen;  methylprednisolone;  mycophenolate mofetil;  tacrolimus;  cyclosporine;  immunosuppressive agent;  tacrolimus, adult;  Article;  controlled study;  descriptive research;  end stage renal disease;  female;  focal glomerulosclerosis;  glomerular dysfunction;  graft recipient;  graft survival;  histopathology;  human;  human tissue;  immune complex nephritis;  immunoglobulin A nephropathy;  immunosuppressive treatment;  kidney transplantation;  low drug dose;  lupus erythematosus nephritis;  major clinical study;  male;  membranous glomerulonephritis;  recurrence risk;  retrospective study;  treatment outcome;  treatment response;  chronic kidney failure;  drug effect;  focal glomerulosclerosis;  glomerulonephritis;  immunoglobulin A nephropathy;  immunology;  membranous glomerulonephritis;  middle aged;  procedures;  treatment outcome, Adult;  Cyclosporine;  Female;  Glomerulonephritis;  Glomerulonephritis, IGA;  Glomerulonephritis, Membranous;  Glomerulosclerosis, Focal Segmental;  Graft Survival;  Humans;  Immunosuppression;  Immunosuppressive Agents;  Kidney Failure, Chronic;  Kidney Transplantation;  Male;  Middle Aged;  Retrospective Studies;  Tacrolimus;  Treatment Outcome",
    abstract = "Objectives Kidney transplant (KTx) recipients with IgAN as primary disease, were compared with recipients with other causes of renal failure, in terms of long-term outcomes. Methods Ninety-nine KTx recipients with end-stage kidney disease (ESKD) due to IgAN, were retrospectively compared to; i/ a matched case-control group of patients with non-glomerular causes of ESKD, and ii/ four control groups with ESKD due to glomerular diseases; 44 patients with primary focal segmental glomerulosclerosis (FSGS), 19 with idiopathic membranous nephropathy (IMN), 22 with lupus nephritis (LN) and 21 with pauci-immune glomerulonephritis (PIGN). Results At end of the observation period, graft function and survival, were similar between KTx recipients with IgAN and all other groups, but the rate of disease recurrence in the graft differed significantly across groups. The rate of IgAN recurrence in the graft was 23.2%, compared to 59.1% (p<0.0001) in the FSGS group, 42.1% (p = 0.17) in the IMN group, and 0% in the LN and PIGN groups (p = 0.01). IgAN recipients, who were maintained with a regimen containing tacrolimus, experienced recurrence less frequently, compared to those maintained with cyclosporine (p = 0.01). Graft loss attributed to recurrence was significantly higher in patients with FSGS versus all others. Conclusion Recipients with IgAN as primary disease, experienced outcomes comparable to those of recipients with other causes of ESKD. The rate of IgAN recurrence in the graft was significantly lower than the rate of FSGS recurrence, but higher than the one recorded in recipients with LN or PIGN. Tacrolimus, as part of the KTx maintenance therapy, was associated with lower rates of IgAN recurrence in the graft, compared to the rate cyclosporine. © 2021 Lionaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited."
}