Clinical Implication of Latant Mesangial IgA Deposition in Renal Allograft Donors in Korea

Abstract

Objectives: Mesangial IgA deposition is incidentally detected in asymptomatic populations. This study was to investigate the incidence and the latent mesangial IgA deposit in the donor kidney and its course after kidney transplantation. The effects of mesangial IgA deposit on clinical outcome was also evaluated. Methods: Retrospective chart review was conducted of who underwent kidney transplantation with zero time biopsies between January 2008 and December 2010 at Seoul National University Hospital. Incidence, short-term clinical outcome, and presence of mesangial IgA deposition in serial protocol biopsy were assessed. Mesangial IgA deposition was analysed by Electron microscope and immunofluorescent staining. Results: Mesangial IgA deposition and IgA nephropathy were present in 30(9.3%)and 17(5.3%) of the total 321 zero-time allograft biopsies. The 23 of 30 patients were performed serial protocol biopsy. Mesangial IgA deposition of 14 patients were disappeared on the 10th day protocol biopsy. The Mesangial IgA deposition was disappeared within six months in four patients, and one year after in three patients. One patient biopsy was proved IgA nephropathy in 10th day protocol biopsy. another two patients were loss of follow up biopsy after 10th day protocol biopsy. There was no association between clinicopathologic finding and early disappearance of mesangial IgA deposition. Renal function was fair during follow up period. Conclusion: The incidence of mesangial IgA deposit and IgA nephropathy is 14.6% in donor populations. Mesangial IgA depositions in zero-time biopsies were disappeared within one year in majority of the cases, and graft function was maintained while short-term follow-up period. However, more prospective researches are needed.