Anti Phospholipase A2 Receptor 1 Antibodies and Membranous Nephropathy Recurrence After Kidney Transplantation
Year: 2024
Type: article
Study design: Observational Study
Abstract: Introduction Membranous nephropathy can lead to end-stage kidney disease, for which kidney transplantation is the preferred therapy. However, the disease often relapses, which can impact allograft survival. Methods We conducted a prospective multicenter study in France involving 72 patients with membranous nephropathy who were awaiting and then underwent kidney transplantation. In addition, we established a retrospective validation cohort of 65 patients. The primary objective was to evaluate the prognostic significance of pretransplant anti phospholipase A2 receptor 1 (PLA2R1) antibodies on the recurrence of membranous nephropathy. The study also assessed the incidence rate, time to onset, and risk factors for recurrence, as well as allograft outcome. Results The prospective cohort showed a 26% cumulative incidence of membranous nephropathy recurrence after a median follow-up of 23.5 months. This was confirmed by a 28% cumulative incidence after a median follow-up of 67 months in the retrospective cohort. A strong association was found between the presence of anti-PLA2R1 antibodies prior to transplantation and the risk of disease recurrence (risk ratio = 5.9; 95% confidence interval [CI]: 2.3–15.7; P < 0.0001). These results were confirmed in the retrospective cohort. Monitoring of anti-PLA2R1 antibodies in the immediate posttransplant period is of limited value, because recurrence occurred early in the first 6 months (median delay of 5 [3–14] months) after transplantation despite decreasing antibody levels. Conclusion The presence of anti-PLA2R1 antibodies prior to transplantation was a strong predictor of recurrence of allograft membranous nephropathy. An individualized immunomonitoring and management strategy for kidney transplant candidates with anti-PLA2R1-associated membranous nephropathy should be considered.
Source: Kidney International Reports
Authors: Marion Cremoni, Maxime Teisseyre, Olivier Thaunat, Céline Fernandez, Christine Payre, Alan Moutou, Hadi Zarif, Vesna Brglez, Laetitia Albano, Valérie Moal, Georges Mourad, Emmanuel Morelon, Bruno Hurault de Ligny, Philippe Zaoui, Eric Rondeau, Nacera Ouali, Pierre Ronco, Bruno Moulin, Laura Braun-Parvez, Antoine Durrbach, Anne-Elisabeth Heng, Philippe Grimbert, Didier Ducloux, Gilles Blancho, Pierre Merville, Gabriel Choukroun, Yannick Le Meur, Cécile Vigneau, Christophe Mariat, Lionel Rostaing, Jean-François Subra, Jean-Luc Taupin, Gérard Lambeau, Vincent Esnault, Antoine Sicard, Barbara Seitz-Polski
Institutions: Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, Unité de Recherche Clinique Côte d'Azur, Hospices Civils de Lyon, Hôpital Edouard Herriot, Centre Hospitalier Universitaire de Montpellier, Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Aix-Marseille Université, Méditerranée Infection Foundation, Hôpital de la Conception, Microbes Evolution Phylogénie et Infections, Lyon 1 Université, Centre Hospitalier Universitaire de Caen Normandie, Université de Caen Normandie, Centre Hospitalier Universitaire de Grenoble, Université Grenoble Alpes, Assistance Publique – Hôpitaux de Paris, Hôpital Tenon, Maladies rénales fréquentes et rares : des mécanismes moléculaires à la médecine personnalisée, Hôpitaux Universitaires de Strasbourg, Inserm, Université Paris-Saclay, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Bicêtre Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Centre Hospitalier Universitaire de Besançon, Centre Hospitalier Universitaire de Nantes, Institut de Transplantation Urologie en Nephrologie, Nantes Université, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Centre Hospitalier Universitaire Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires, Université de Picardie Jules Verne, Centre Hospitalier Régional Universitaire de Brest, Institut de Recherche en Santé, Environnement et Travail, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Centre Hospitalier Universitaire de Saint-Étienne, Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes Angers, Centre Hospitalier Universitaire d'Angers, Université d'Angers, Hôpital Saint-Louis
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
OpenAlex ID: W4402737478