To Sam, About IGAN Recurrence

[Guest guest]

I saw Marty posted this in an earlier post. I have highlighted a

portion of his post that may be relevant to J.'s recurrence.

" Starting at approximately 5 yr after transplantation, recurrent

disease does become a relevant clinical problem and may result in

graft loss unless it is masked by previous graft failure as a result

of other immune or nonimmune mechanisms, in particular allograft

rejection.

Immunosuppression with corticosteroids, azathioprine, and/or

cyclosporin A does not prevent recurrent IgAN, either histologically

or clinically. Whether newer immunosuppressants, e.g., mycophenolate

mofetil, can prevent the recurrence or may be effective in instances

of recurrent IgAN as suggested by a recent case report (60) remains

to be established.

The clinical relevance of recurrent IgAN seems largely to be a

function of the time posttransplantation and cannot be predicted by

other variables.

Patients who have already lost a graft as a result of recurrent IgAN

may be at particularly high risk for repeated graft loss because of

recurrence upon retransplantation. "