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Abstract: TH-PO0920

Adverse Outcomes Associated with IgAN Recurrence in Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Onyeaghala, Guillaume Chinedu, UTMB, Galveston, Texas, United States
  • Gupta, Kajal, UTMB, Galveston, Texas, United States
  • Ammar, Shahed, UTMB, Galveston, Texas, United States
  • Hussain, Syed A., UTMB, Galveston, Texas, United States
  • Rizvi, Asim, UTMB, Galveston, Texas, United States
  • Hassan, Syed F, UTMB, Galveston, Texas, United States
  • Khanipov, Kamil, UTMB, Galveston, Texas, United States
  • Golovko, George, UTMB, Galveston, Texas, United States
  • Kueht, Michael, UTMB, Galveston, Texas, United States
  • Lee, John Richard, Weill Cornell Medicine, New York, New York, United States
  • Gamilla-Crudo, Ann Kathleen N., UTMB, Galveston, Texas, United States
  • Wadhwani, Shikha, UTMB, Galveston, Texas, United States
  • Israni, Ajay K., UTMB, Galveston, Texas, United States
Background

IgAN is the leading cause of glomerulonephritis worldwide and affected individuals have a high lifetime risk of end-stage kidney disease (ESKD). While kidney transplantation is the preferred option for those who progress to ESKD, there is a risk of IgAN recurrence in the transplanted kidney. Our study analyzed adverse outcomes associated with IgAN recurrence in kidney transplant recipients (KTRs) using the TriNetX database.

Methods

A propensity score matched study of outcomes in KTRs with IgAN as the primary reason for kidney transplantation was performed in TriNetX between 12/31/2010 and 12/31/2024. Outcomes of interest included IgAN recurrence, transplant rejection, and cytomegalovirus (CMV) infection post-transplant. Exposures and outcomes of interest were defined using composite ICD and CPT codes. Cohorts were matched based on age, sex, race, ethnicity, BMI, and donor status.

Results

There were 1603 KTRs who had IgAN as a primary diagnosis prior to transplantation in the TrinetX database, and 970 (64.3%) experienced IgAN recurrence over 5 years. After propensity score matching, 641 KTRs were retained in each group. KTRs with IgAN recurrence had 1.27 times greater risk of transplant rejection (95% CI: 1.06-1.51) and 1.49 times greater risk of CMV infection (95% CI: 1.22 – 1.82) than KTRs without IgAN recurrence during the follow up period (Fig1).

Conclusion

Our study found that KTRs with IgAN recurrence in the TrinetX database had significantly greater risk of rejection and CMV infection post-transplant. Despite limitations in the generalizability of electronic heath records data, this represents an opportunity for further insight into differences in the early post-transplant period to identify modifiable risk factors associated with IgA recurrence in KTRs.

Digital Object Identifier (DOI)