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Outcome of kidney transplantation in pediatric patients with ANCA-associated glomerulonephritis: a single-center experience

Objectives Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our... Full description

Journal Title: Pediatric nephrology (Berlin West), 2017-08-01, Vol.32 (12), p.2343-2350
Main Author: Noone, Damien
Other Authors: Yeung, Rae S. M , Hebert, Diane
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28766066
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title: Outcome of kidney transplantation in pediatric patients with ANCA-associated glomerulonephritis: a single-center experience
format: Article
creator:
  • Noone, Damien
  • Yeung, Rae S. M
  • Hebert, Diane
subjects:
  • Adolescent
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - mortality
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - therapy
  • Antibodies, Antineutrophil Cytoplasmic - blood
  • Antineutrophil cytoplasmic antibodies
  • Child
  • Cyclophosphamide
  • Diagnosis
  • Dialysis
  • End-stage renal disease
  • Epidermal growth factor receptors
  • Female
  • Glomerular filtration rate
  • Glomerulonephritis
  • Glomerulonephritis - etiology
  • Glomerulonephritis - mortality
  • Glomerulonephritis - therapy
  • Graft rejection
  • Granulomatosis
  • Health aspects
  • Humans
  • Immunosuppression
  • Kidney - physiopathology
  • Kidney diseases
  • Kidney Failure, Chronic - etiology
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - therapy
  • Kidney transplantation
  • Kidney Transplantation - adverse effects
  • Kidney Transplantation - methods
  • Kidneys
  • Male
  • Medicine
  • Medicine & Public Health
  • Nephrology
  • Original Article
  • Patient outcomes
  • Patients
  • Pediatrics
  • Retrospective Studies
  • Steroid hormones
  • Syngeneic grafts
  • Transplantation
  • Transplants & implants
  • Treatment Outcome
  • Urology
  • Vasculitis
ispartof: Pediatric nephrology (Berlin, West), 2017-08-01, Vol.32 (12), p.2343-2350
description: Objectives Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. Methods We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014. Results Since 2000, there were seven pediatric patients with ANCA GN (four MPA) transplanted. Mean age at ANCA GN diagnosis was 11.8 ± 2.8 (range, 7.2–15.4) years. All seven were ANCA (three anti-PR3/four anti-MPO) positive. Estimated glomerular filtration rate (eGFR) at diagnosis was 11.7 ± 6.3 ml/min/1.73 m 2 . All received steroids and cyclophosphamide and three (23.3%) received plasma exchange. Six were dialysis dependent by 6 months post diagnosis. Time from diagnosis to transplant was 30 ± 12 (range, 17–48) months. Six of the seven received a deceased donor transplant. All patients received induction therapy and standard maintenance immunosuppression post transplant. Median duration of follow-up post transplantation was 27 months (range, 13–88 months). Median eGFR at last follow-up was 77 ml/min/1.73 m 2 (range, 7.9–83.5). One patient lost her transplant to acute cellular rejection following non-adherence to immunosuppression after 21 months of stable transplant function. No patient had recurrence of vasculitis, either renal or extra-renal. Conclusions Short-term patient and allograft survival in pediatric patients with ESRD secondary to ANCA GN seems excellent, with no recurrence of vasculitis post transplant in this small cohort.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titleOutcome of kidney transplantation in pediatric patients with ANCA-associated glomerulonephritis: a single-center experience
creatorNoone, Damien ; Yeung, Rae S. M ; Hebert, Diane
creatorcontribNoone, Damien ; Yeung, Rae S. M ; Hebert, Diane
descriptionObjectives Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. Methods We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014. Results Since 2000, there were seven pediatric patients with ANCA GN (four MPA) transplanted. Mean age at ANCA GN diagnosis was 11.8 ± 2.8 (range, 7.2–15.4) years. All seven were ANCA (three anti-PR3/four anti-MPO) positive. Estimated glomerular filtration rate (eGFR) at diagnosis was 11.7 ± 6.3 ml/min/1.73 m 2 . All received steroids and cyclophosphamide and three (23.3%) received plasma exchange. Six were dialysis dependent by 6 months post diagnosis. Time from diagnosis to transplant was 30 ± 12 (range, 17–48) months. Six of the seven received a deceased donor transplant. All patients received induction therapy and standard maintenance immunosuppression post transplant. Median duration of follow-up post transplantation was 27 months (range, 13–88 months). Median eGFR at last follow-up was 77 ml/min/1.73 m 2 (range, 7.9–83.5). One patient lost her transplant to acute cellular rejection following non-adherence to immunosuppression after 21 months of stable transplant function. No patient had recurrence of vasculitis, either renal or extra-renal. Conclusions Short-term patient and allograft survival in pediatric patients with ESRD secondary to ANCA GN seems excellent, with no recurrence of vasculitis post transplant in this small cohort.
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1EISSN: 1432-198X
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subjectAdolescent ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - mortality ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - therapy ; Antibodies, Antineutrophil Cytoplasmic - blood ; Antineutrophil cytoplasmic antibodies ; Child ; Cyclophosphamide ; Diagnosis ; Dialysis ; End-stage renal disease ; Epidermal growth factor receptors ; Female ; Glomerular filtration rate ; Glomerulonephritis ; Glomerulonephritis - etiology ; Glomerulonephritis - mortality ; Glomerulonephritis - therapy ; Graft rejection ; Granulomatosis ; Health aspects ; Humans ; Immunosuppression ; Kidney - physiopathology ; Kidney diseases ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidney Transplantation - methods ; Kidneys ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Patient outcomes ; Patients ; Pediatrics ; Retrospective Studies ; Steroid hormones ; Syngeneic grafts ; Transplantation ; Transplants & implants ; Treatment Outcome ; Urology ; Vasculitis
ispartofPediatric nephrology (Berlin, West), 2017-08-01, Vol.32 (12), p.2343-2350
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0IPNA 2017
1COPYRIGHT 2017 Springer
2Pediatric Nephrology is a copyright of Springer, 2017.
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descriptionObjectives Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. Methods We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014. Results Since 2000, there were seven pediatric patients with ANCA GN (four MPA) transplanted. Mean age at ANCA GN diagnosis was 11.8 ± 2.8 (range, 7.2–15.4) years. All seven were ANCA (three anti-PR3/four anti-MPO) positive. Estimated glomerular filtration rate (eGFR) at diagnosis was 11.7 ± 6.3 ml/min/1.73 m 2 . All received steroids and cyclophosphamide and three (23.3%) received plasma exchange. Six were dialysis dependent by 6 months post diagnosis. Time from diagnosis to transplant was 30 ± 12 (range, 17–48) months. Six of the seven received a deceased donor transplant. All patients received induction therapy and standard maintenance immunosuppression post transplant. Median duration of follow-up post transplantation was 27 months (range, 13–88 months). Median eGFR at last follow-up was 77 ml/min/1.73 m 2 (range, 7.9–83.5). One patient lost her transplant to acute cellular rejection following non-adherence to immunosuppression after 21 months of stable transplant function. No patient had recurrence of vasculitis, either renal or extra-renal. Conclusions Short-term patient and allograft survival in pediatric patients with ESRD secondary to ANCA GN seems excellent, with no recurrence of vasculitis post transplant in this small cohort.
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1Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications
2Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - mortality
3Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - therapy
4Antibodies, Antineutrophil Cytoplasmic - blood
5Antineutrophil cytoplasmic antibodies
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7Cyclophosphamide
8Diagnosis
9Dialysis
10End-stage renal disease
11Epidermal growth factor receptors
12Female
13Glomerular filtration rate
14Glomerulonephritis
15Glomerulonephritis - etiology
16Glomerulonephritis - mortality
17Glomerulonephritis - therapy
18Graft rejection
19Granulomatosis
20Health aspects
21Humans
22Immunosuppression
23Kidney - physiopathology
24Kidney diseases
25Kidney Failure, Chronic - etiology
26Kidney Failure, Chronic - mortality
27Kidney Failure, Chronic - therapy
28Kidney transplantation
29Kidney Transplantation - adverse effects
30Kidney Transplantation - methods
31Kidneys
32Male
33Medicine
34Medicine & Public Health
35Nephrology
36Original Article
37Patient outcomes
38Patients
39Pediatrics
40Retrospective Studies
41Steroid hormones
42Syngeneic grafts
43Transplantation
44Transplants & implants
45Treatment Outcome
46Urology
47Vasculitis
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authorNoone, Damien ; Yeung, Rae S. M ; Hebert, Diane
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1Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications
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26Kidney Failure, Chronic - mortality
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33Medicine
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35Nephrology
36Original Article
37Patient outcomes
38Patients
39Pediatrics
40Retrospective Studies
41Steroid hormones
42Syngeneic grafts
43Transplantation
44Transplants & implants
45Treatment Outcome
46Urology
47Vasculitis
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abstractObjectives Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. Methods We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014. Results Since 2000, there were seven pediatric patients with ANCA GN (four MPA) transplanted. Mean age at ANCA GN diagnosis was 11.8 ± 2.8 (range, 7.2–15.4) years. All seven were ANCA (three anti-PR3/four anti-MPO) positive. Estimated glomerular filtration rate (eGFR) at diagnosis was 11.7 ± 6.3 ml/min/1.73 m 2 . All received steroids and cyclophosphamide and three (23.3%) received plasma exchange. Six were dialysis dependent by 6 months post diagnosis. Time from diagnosis to transplant was 30 ± 12 (range, 17–48) months. Six of the seven received a deceased donor transplant. All patients received induction therapy and standard maintenance immunosuppression post transplant. Median duration of follow-up post transplantation was 27 months (range, 13–88 months). Median eGFR at last follow-up was 77 ml/min/1.73 m 2 (range, 7.9–83.5). One patient lost her transplant to acute cellular rejection following non-adherence to immunosuppression after 21 months of stable transplant function. No patient had recurrence of vasculitis, either renal or extra-renal. Conclusions Short-term patient and allograft survival in pediatric patients with ESRD secondary to ANCA GN seems excellent, with no recurrence of vasculitis post transplant in this small cohort.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid28766066
doi10.1007/s00467-017-3749-6
orcididhttps://orcid.org/0000-0003-3385-6174