关键词: 肾移植, IgA肾病, 复发

Abstract:

IgA nephropathy (IgAN) is the most common primary glomerulonephritis in both the native kidney and renal allografts. The reported incidence of IgAN recurrence after renal transplantation varies from 45% to 705%. Main risk factors for IgAN recurrence include IgA deposition in the donor kidney, livingrelated donor, younger recipients, rapid progress in the native kidney, massive urinary protein excretion, the representative pathogenic genes of IgA nephropathy, early steroid withdrawal after kidney transplantation and high HLA mismatch. With further studies, it was found that the recurrence of IgAN could influence allograft longterm survival. Histopathological changes influencing allograft prognosis include crescent formation, glomerulosclerosis, interstital fibrosis, diffuse mesangial proliferation with segmental glomerulosclerosis or formation of crescents. Currently, treatment protocols for recurrent allograft IgAN are similar with those used for IgAN of the native kidneys. Highdose steroids or cyclophosphamide also can be administered for selected patients who respond poorly to conventional therapies. Nevertheless, new therapeutic regimens are still needed to improve allograft survival.

Key words: renal transplantation, IgA nephropathy, recurrence