Prevalence, Characteristics, and Outcomes of Incidental IgA Glomerular Deposits in Donor Kidneys
Lillian W. Gaber, Faiza Nafees Khan, Edward A. Graviss, Duc T. Nguyen, Linda W. Moore, Luan D. Truong, Roberto Barrios, Wadi N. Suki
Abstract
INTRODUCTION: Incidental IgA deposits in donor kidneys have unknown sequelae and may predate clinical kidney disease if primed by adverse immunologic or hemodynamic stimuli or may remain dormant. METHODS: ) biopsies from living (LDK) and deceased donor (DDK) kidneys, and its relationship to post-transplant patient and graft outcomes was investigated in an ethnically diverse US population at a large transplant center. RESULTS: IgA+ biopsies. Mesangial pathology correlated with higher-intensity IgA staining with less clearance on follow-up (53.8%) versus 79.2% without mesangial pathology. IgA cleared in 91%, 63%, and 40% of follow-up biopsies with 1+, 2+, and 3+ IgA staining, respectively. Early post-transplant rejection and rejection-related graft loss occurred more frequently in IgA+ kidney recipients; however, 5-year kidney function and graft survival were comparable to kidneys without IgA. CONCLUSION: biopsy deserve careful follow-up.