RENAL-TRANSPLANTATION IN PATIENTS WITH MICROSCOPIC POLYARTERITIS AND ANTIMYELOPEROXIDASE ANTIBODIES - REPORT OF 3 CASES

This paper reports on 3 patients on renal dialysis for crescentic glom erulonephritis associated with microscopic polyarteritis (MPA) and ant ineutrophil cytoplasmic autoantibodies specific for myeloperoxidase (M PO-ANCAs). They successfully underwent renal transplantation from a ca daver donor 6-63 months after the onset of the disease, despite the pe rsistence of antibodies at high titer. A triple immunosuppressive regi men including steroids, cyclosporin and azathioprine was used. One pat ient underwent transplantectomy for surgical complications 3 months la ter, while the serum creatinine was 2.0 mg/dl (178 mu mol/l): the rema inder have a well-functioning graft after 21 and 38 months, no clinica l sign of disease recurrence, and a MPO titer within the normal range. We conclude that MPA patients can undergo renal transplantation even if ANCAs persist at a high titer in the circulation.