Kidney Week

Abstract: TH-PO758

Outcomes after Kidney Transplantation in ANCA-Associated Vasculitis

Session Information

• Transplantation: Clinical - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Brilland, Benoit, CHU Angers, Angers, France

Benoit Brilland, MD, PhD

• Dekervel, Marine, CHU Angers, Angers, France

Marine Dekervel

• Traversat, Priscille, CHU Angers, Angers, France

Priscille Traversat

• Thierry, Antoine, Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Antoine Thierry, MD, PhD

• Golbin, Leonard, CHU Rennes, Rennes, France

Leonard Golbin

• Bertrand, Dominique, CHU Rouen, Rouen, France

Dominique Bertrand, MD

• Cornec-Le Gall, Emilie, CHU Brest, Brest, France

Emilie Cornec-Le Gall, MD, PhD

• Piccoli, Giorgina B., Centre Hospitalier du Mans, Le Mans, Pays de la Loire, France

Giorgina B. Piccoli, MD

• Djema, Assia Ilham, Centre Hospitalier de Cholet, Cholet, France

Assia Ilham Djema, MD

• Henry, Nicolas, CH Laval, Laval, France

Nicolas Henry, MD

• Duveau, Agnes, CHU Angers, Angers, France

Agnes Duveau, MD

• Anglicheau, Dany, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, France

Dany Anglicheau, MD, PhD

• Chatelet Pouliquen, Valerie, Centre Hospitalier Universitaire de Caen Normandie, Caen, Normandie, France

Valerie Chatelet Pouliquen, NP

• Caillard, Sophie, CHU Strasbourg, Strasbourg, France

Sophie Caillard, MD, PhD

• Duthe, Fabien, Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Fabien Duthe, PhD

• Gatault, Philippe, CHU Tours, Tours, France

Philippe Gatault

• Augusto, Jean Francois, Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Jean Francois Augusto, MD, PhD

Group or Team Name

• Spiesser Group.

Background

ANCA-associated glomerulonephritis (AAV-GN) frequently leads to end-stage kidney disease (ESKD), requiring replacement therapy with dialysis or kidney transplant (KT). Few large studies evaluated the outcome of these patients after KT. Our aim was to describe, in comparison with a control group, the occurrence of delayed graft function, graft failure, relapse, acute rejection, death; and to study the risk factors associated with these events.

Methods

This was a retrospective, multicenter (8 French centers), observational study including patients who received a KT between 2005 and 2023 for ESKD secondary to AAV-GN. Each vasculitis case receiving a KT was matched with 2 controls, matched on gender, center, recipient age (± 5 years) and transplant period (± 1 year). Event-free survival and the associated risk factors were analyzed.

Results

474 patients were included, including 158 with AAV-GN and 316 control patients. The median post-KT follow-up for vasculitis patients was 5.3 years. There was no difference in the occurrence of DGF between the groups (17.9 vs 18.3 %, p = 1.0). In multivariable analysis, graft survival tended to be lower in the AAV-GN group compared to the controls (76% vs 81% at 10 years, p = 0.057, Figure 1A). 11 patients experienced a relapse after KT. ANCA positivity at the time of transplantation appeared to be correlated with relapse. There was no difference in the incidence of acute rejection between the groups (p = 0.4). In multivariable analysis, overall survival was not significantly lower in AAV-GN patients compared to controls (60% vs 72% at 10 years, p = 0.13, Figure 1B).

Conclusion

Kidney transplantation is a valuable option for patients with AAV-GN: the relapse rate is low, and the occurrence of acute rejection is comparable to a population of control patients. However, in AAV-GN, graft survival appears to be poorer when compared to control patients.

Figure 1. Kidney (A) and overall (B) survival after kidney transplantation.