Renal transplantation in anti-neutrophil cytoplasmic antibody-associated vasculitis

Zdenka Hruskova, Duvuru Geetha, Vladimir Tesar

Research output: Contribution to journalReview articlepeer-review

Abstract

Despite major advances in the management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) achieved in the last decades, a large proportion of AAV patients still develop end-stage renal disease. The survival of AAV patients dependent on dialysis is significantly worse compared with dialysis-independent AAV patients, but is comparable to other non-diabetic patients requiring dialysis. Renal transplantation (RTx) is the method of choice among renal replacement therapies and there has been increasing evidence that it is a suitable method with favorable patient-and graft-survival also in AAV patients. It is recommended to perform RTx after â ‰1 12 months of remission, and ANCA positivity at the time of RTx is generally not considered a contraindication. Even though the risk of relapse after RTx is relatively low with current post-transplant immunosuppressive regimens, disease recurrence may occur. Besides cyclophosphamide, rituximab might become a therapeutic alternative for post-transplant AAV recurrence in the near future but its efficacy and safety in this setting needs to be confirmed in larger studies.

Original languageEnglish (US)
Pages (from-to)i159-i163
JournalNephrology Dialysis Transplantation
Volume30
DOIs
StatePublished - Sep 30 2015

Keywords

  • ANCA
  • outcome
  • relapse
  • renal transplantation
  • vasculitis

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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