Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation
Due to complex comorbidity, high infectious complication rates, an elevated risk of relapsing for primary renal disease, as well as inferior recipient and allograft survivals, individuals with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs) are often considered as poor trans...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/12/1325 |
| _version_ | 1827671232044072960 |
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| author | Valentina Binda Evaldo Favi Marta Calatroni Gabriella Moroni |
| author_facet | Valentina Binda Evaldo Favi Marta Calatroni Gabriella Moroni |
| author_sort | Valentina Binda |
| collection | DOAJ |
| description | Due to complex comorbidity, high infectious complication rates, an elevated risk of relapsing for primary renal disease, as well as inferior recipient and allograft survivals, individuals with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs) are often considered as poor transplant candidates. Although several aspects of recurrent and de novo AAVs remain unclear, recent evidence suggests that kidney transplantation (KT) represents the best option, which is also the case for this particular subgroup of patients. Special counselling and individualized approaches are strongly recommended at the time of enlistment and during the entire post-transplant follow-up. Current strategies include avoiding transplantation within one year of complete clinical remission and thoroughly assessing the recipient for early signs of renal or systemic vasculitis. The main clinical manifestations of allograft AAV are impaired kidney function, proteinuria, and hematuria with ANCA positivity in most cases. Mixed results have been obtained using high-dose steroids, mycophenolate mofetil, or cyclophosphamide. The aim of the present review was to summarize the available literature on AAVs in KT, particularly focusing on de novo pauci-immune glomerulonephritis. |
| first_indexed | 2024-03-10T03:37:13Z |
| format | Article |
| id | doaj.art-759e705e853143ffab4abe5ebe54c881 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T03:37:13Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-759e705e853143ffab4abe5ebe54c8812023-11-23T09:28:24ZengMDPI AGMedicina1010-660X1648-91442021-12-015712132510.3390/medicina57121325Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney TransplantationValentina Binda0Evaldo Favi1Marta Calatroni2Gabriella Moroni3Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyKidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, 20089 Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, 20089 Rozzano, ItalyDue to complex comorbidity, high infectious complication rates, an elevated risk of relapsing for primary renal disease, as well as inferior recipient and allograft survivals, individuals with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs) are often considered as poor transplant candidates. Although several aspects of recurrent and de novo AAVs remain unclear, recent evidence suggests that kidney transplantation (KT) represents the best option, which is also the case for this particular subgroup of patients. Special counselling and individualized approaches are strongly recommended at the time of enlistment and during the entire post-transplant follow-up. Current strategies include avoiding transplantation within one year of complete clinical remission and thoroughly assessing the recipient for early signs of renal or systemic vasculitis. The main clinical manifestations of allograft AAV are impaired kidney function, proteinuria, and hematuria with ANCA positivity in most cases. Mixed results have been obtained using high-dose steroids, mycophenolate mofetil, or cyclophosphamide. The aim of the present review was to summarize the available literature on AAVs in KT, particularly focusing on de novo pauci-immune glomerulonephritis.https://www.mdpi.com/1648-9144/57/12/1325chronic kidney diseasekidney transplantANCA-associated vasculitispauci-immune glomerulonephritispatient survivalgraft survival |
| spellingShingle | Valentina Binda Evaldo Favi Marta Calatroni Gabriella Moroni Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation Medicina chronic kidney disease kidney transplant ANCA-associated vasculitis pauci-immune glomerulonephritis patient survival graft survival |
| title | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation |
| title_full | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation |
| title_fullStr | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation |
| title_full_unstemmed | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation |
| title_short | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Kidney Transplantation |
| title_sort | anti neutrophil cytoplasmic antibody associated vasculitis in kidney transplantation |
| topic | chronic kidney disease kidney transplant ANCA-associated vasculitis pauci-immune glomerulonephritis patient survival graft survival |
| url | https://www.mdpi.com/1648-9144/57/12/1325 |
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