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P8.061 Recurrence of Membranoproliferative Glomerulonephritis After Kidney Transplantation: Risk Factors and Impact on Graft Function and Survival

Marcos Sousa, Brazil

University of Campinas - UNICAMP

Abstract

Recurrence of membranoproliferative glomerulonephritis after kidney transplantation: risk factors and impact on graft function and survival

Lais de Paula1, Marcos Sousa1, Marilda Mazzali1.

1Internal Medicine, University of Campinas - UNICAMP, Campinas - Sao Paulo, Brazil

Transplant Research Laboratory.

Introduction: Membranoproliferative glomerulonephritis (MPGN) is a heterogeneous group of glomerular diseases differing in etiopathogenesis, electron microscopy features, and immunofluorescence patterns. The MPGN corresponds to 7-10% of all cases of glomerulonephritis and is an uncommon cause of end-stage renal disease (ESRD). Recurrence after transplantation ranges from 11.8% to 18.9% after 5 and 15 years, respectively. This study aimed to assess the risk factors of MPGN recurrence after kidney transplantation and its impact on function and graft survival.

Methods: Single-center retrospective cohort, including renal transplant recipients older than 18 years, with diagnosis of MPGN in native kidneys. Clinical and laboratory data were obtained from medical records.

Results: Forty-three patients fulfill the inclusion criteria, majority male (60.4%), mean age of 26.5 + 9.8 years. All patients presented proteinuria at MPGN diagnosis in native kidneys, with nephrotic syndrome occurred in 79%. MPGN was associated with Hepatitis C (VHC) infection in eight (18.6%) patients, Schistosoma mansoni infection in seven (16.3%), and Hepatitis B in two (4.6%). Post-transplant recurrence of MPGN occurred in 10 (23.3%) patients, majority male (70%), recipients from a living donor kidney (60%) after a median time of 19.8 (2-72) months. All patients with MPGN recurrence had nephrotic syndrome at diagnosis, and 60.0% presented C3 consumption. Seven (70%) patients with MPGN recurrence had graft failure, and two (20.0%) presented death with a functioning graft. The graft failure rate in the MPGN recurrence group was similar that group without recurrence.

Conclusions: In this series, the GNMP recurrence was around 25%, most frequently in recipients of kidneys from living donors, similar to other studies. All patients with MPGN recurrence had nephrotic syndrome at diagnosis, and most of them presented C3 consumption. The rate of allograft failure was similar to GNMP without recurrence.

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