2016 Volume 4 Issue 1 Pages 107-112
Several analyses have found that the risk of recurrence of IgA glomerulonephritis is higher among recipients of living-related donor kidneys than among those of cadaveric donor kidneys； however, these risks are unknown in Japan. Here, we analyzed mesangial IgA deposition among kidney transplant patients in Nagasaki prefecture, Japan. We studied both the rate of IgA deposition and outcomes after renal transplantation in 205 patients who received a renal graft between 1978 and 2015 in Nagasaki prefecture. In the patients with biopsy-verified IgA glomerulonephritis or purpura nephritis (28 living-related donor, 11 cadaveric donor), there was no statistically significant difference in IgA deposits between living-related donor grafts and cadaveric ones. After including chronic glomerulonephritis patients whose primary disease was not biopsy-proven but could not be excluded as IgA glomerulonephritis, mesangial IgA deposits were observed with a significantly higher incidence in recipients of a living-related donor graft (32/86 living-related donor vs 14/65 cadaveric donor). In spite of IgA deposition, cumulative graft survival was not reduced in both living-related and cadaveric donor recipients. The proportion of IgA deposits was higher among recipients of living-related donor kidneys than among those of cadaveric donor kidneys. Among living-related donors, most donors were blood relatives, and therefore a genetic influence may exist. IgA deposition did not affect the graft survival in this study. Even after considering the cumulative evidence, the recurrence of IgA glomerulonephritis had a negligible influence on late graft survival. We should pay attention to the renal prognosis of recipients whose primary disease is IgA glomerulonephritis.
