Prevalence and predictors of recurrent IgA nephropathy following renal transplantation

Background IgA nephropathy is a common glomerulonephritis for which there i s no effective cure, It may recur after renal transplantation and cause gra ft loss. Aims To determine the prevalence and predict recurrence of IgA disease in t ransplant recipients, Methods A retrospective analysis was performed of ail renal allografts in p atients with IgA disease attending a National Renal Unit between 1984 and 1 995, An immunopathological grading system was devised to assess the severit y of disease at initial presentation and each patient was assigned a simple severity index. Results A total of 42 patients with IgA disease received 44 renal allograft s. Biopsies were performed in 21 of the 44 transplants. Recurrence was diag nosed in five grafts (24%) and recurred only in the 'moderate' and 'severe' IgA groups. Recurrence was associated with younger age, glomerular crescen ts on the original renal biopsy, better donor/recipient HLA matching and gr eater number of rejections. Conclusion The prevalence of recurrent IgA disease following transplantatio n in an Irish population is less than that reported at other centres (24% v ersus 60%). The severity of the original disease and transplant factors may predict recurrence post-transplantation.