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Recurrence of membranous nephropathy after kidney transplantation: A multicenter retrospective cohort study

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dc.contributor.author Hullekes, Frank
dc.contributor.author Buxeda, Anna
dc.contributor.author Pérez-Sáez, María José
dc.contributor.author Arias Cabrales, Carlos Enrique
dc.contributor.author Riella, Leonardo V.
dc.date.accessioned 2024-09-27T06:20:57Z
dc.date.available 2024-09-27T06:20:57Z
dc.date.issued 2024
dc.identifier.citation Hullekes F, Uffing A, Verhoeff R, Seeger H, von Moos S, Mansur J, et al. Recurrence of membranous nephropathy after kidney transplantation: A multicenter retrospective cohort study. Am J Transplant. 2024 Jun;24(6):1016-26. DOI: 10.1016/j.ajt.2024.01.036
dc.identifier.issn 1600-6135
dc.identifier.uri http://hdl.handle.net/10230/61255
dc.description.abstract Membranous nephropathy (MN) is a leading cause of kidney failure worldwide and frequently recurs after transplant. Available data originated from small retrospective cohort studies or registry analyses; therefore, uncertainties remain on risk factors for MN recurrence and response to therapy. Within the Post-Transplant Glomerular Disease Consortium, we conducted a retrospective multicenter cohort study examining the MN recurrence rate, risk factors, and response to treatment. This study screened 22,921 patients across 3 continents and included 194 patients who underwent a kidney transplant due to biopsy-proven MN. The cumulative incidence of MN recurrence was 31% at 10 years posttransplant. Patients with a faster progression toward end-stage kidney disease were at higher risk of developing recurrent MN (hazard ratio [HR], 0.55 per decade; 95% confidence interval [CI], 0.35-0.88). Moreover, elevated pretransplant levels of anti-phospholipase A2 receptor (PLA2R) antibodies were strongly associated with recurrence (HR, 18.58; 95% CI, 5.37-64.27). Patients receiving rituximab for MN recurrence had a higher likelihood of achieving remission than patients receiving renin-angiotensin-aldosterone system inhibition alone. In sum, MN recurs in one-third of patients posttransplant, and measurement of serum anti-PLA2R antibody levels shortly before transplant could aid in risk-stratifying patients for MN recurrence. Moreover, patients receiving rituximab had a higher rate of treatment response.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Am J Transplant. 2024 Jun;24(6):1016-26
dc.rights © 2024 The Authors. Published by Elsevier Inc. on behalf of American Society of Transplantation & American Society of Transplant Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.other Ronyons--Malalties
dc.subject.other Ronyons--Trasplantació
dc.title Recurrence of membranous nephropathy after kidney transplantation: A multicenter retrospective cohort study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.ajt.2024.01.036
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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