Division of Nephrology and Dialysis, Department of CardioRenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Clin Transplant. 2013 Nov-Dec;27 Suppl 26:14-21. doi: 10.1111/ctr.12158.
Latent mesangial immunoglobulin A (IgA) deposition in the donated kidney has been investigated in the context of kidney transplantation. However, few studies have examined the impact of mesangial expansion accompanied with IgA deposition. Therefore, we investigated the effects of latent IgA deposition and mesangial expansion on transplant prognosis following living-donor kidney transplantation.
We retrospectively analyzed 68 consecutive adult living-donor kidney transplantations performed at Kagawa University Hospital. Biopsies were performed at pre-implantation and at one year after transplantation.
Twenty kidneys exhibited latent IgA deposition in pre-implantation biopsies, including 14 with mesangial expansion. Latent IgA deposition was not associated with renal function or donor urinalysis after donation, irrespective of mesangial expansion. Latent IgA deposition was not significantly associated with graft survival rate, allograft function, abnormal urinalysis, or the recurrence of IgA nephropathy, irrespective of mesangial expansion. At one year after transplantation, IgA deposition had disappeared in 14/20 allografts. Estimated glomerular function rate >40 mL/min/1.73 m(2) was significantly associated with the disappearance of IgA deposition.
The present study showed that latent IgA deposition from the donor kidney, irrespective of mesangial expansion, does not affect transplant prognosis following living-donor kidney transplantation.
在肾移植背景下,已对供体肾脏中的潜在系膜免疫球蛋白 A(IgA)沉积进行了研究。然而,很少有研究探讨伴有 IgA 沉积的系膜扩张的影响。因此,我们研究了活体供肾移植后潜在 IgA 沉积和系膜扩张对移植预后的影响。
我们回顾性分析了在香川县大学医院进行的 68 例连续成人活体供肾移植。在移植前和移植后 1 年进行活检。
20 例移植肾在移植前活检中存在潜在 IgA 沉积,其中 14 例伴有系膜扩张。潜在 IgA 沉积与供体捐赠后的肾功能或尿液分析无关,无论系膜扩张与否。潜在 IgA 沉积与移植物存活率、同种异体肾功能、异常尿液分析或 IgA 肾病复发均无显著相关性,无论系膜扩张与否。在移植后 1 年,20 例移植肾中的 14 例 IgA 沉积已消失。肾小球滤过率估计值>40 mL/min/1.73 m(2)与 IgA 沉积的消失显著相关。
本研究表明,无论系膜扩张与否,来自供体肾脏的潜在 IgA 沉积不会影响活体供肾移植后的移植预后。