关键词: 抗中性粒细胞胞质抗体相关性肾炎, 慢性肾功能不全, 肾移植预后

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To retrospectively analyze the outcome of kidney allograft for ESRD resulted from ANCAassociated glomerulonephritis（AAGN）.
Ｍｅｔｈｏｄｏｌｏｇｙ：Eleven patients with AAGN who received renal transplantation (RTx) between 1994 and 2013 were enrolled in this study. Overall allograft outcome, AAV recurrence and the association of the serum ANCA titer with allograft outcome were investigated.
Ｒｅｓｕｌｔｓ：All  ESRD cases  were resulted from microscopic polyangiitis (MPA). Ten patients received renal replacement therapy（RRT）before RTx, with median time of 305 (148～505) months. Theres no clinic activity of AAV with BVAS of zero,The median followup was 56（465～135）months after RTx. Only one patient (909%) experienced AAV recurrence,while four (364%) had acute rejection, and one (909%) had chronic rejection. At the endpoint of followup, eight (727%) patients had normal allograft function, while renal insufficiency happened in three patients (273%), in which one had allograft failure. There was no death during followup. Five years survival rate in patient and allograft was 100% and 90.9% respectively. No significant differences were found in allograft failure, AAV recurrence and rejection in patients differed by serum ANCA titer at RTx time.
Ｃｏｎｃｌｕｓｉｏｎ：
RTx is a safe and effective option for ESRD secondary to AAV. AAV recurrence was rare under current immunosuppression strategy. However, acute rejections may need more attention and prevention.

Key words: ANCA-associated glomerulonephritis, end-stage renal disease, renal transplantation, outcome