Renal transplant in Wegener's granulomatosis compared to microscopic polyangiitis.

Abstract

Antineutrophil cytoplasmic antibody-associated vasculitis is an important cause of endstage renal disease. Our aim was to investigate how the underlying vasculitis diagnosis may influence outcomes following renal transplant. We undertook a retrospective cohort study of patients who underwent renal transplant at the Johns Hopkins Hospital between 1999 and 2008. Detailed followup data were available for 11 patients with Wegener's granulomatosis (WG) and 6 with microscopic polyangiitis (MPA), representing 799 patient-months of observation. Patients with WG remained on hemodialysis longer (and may have had slightly worse renal outcomes following transplant) than patients with MPA. Four patients with WG experienced adverse events following renal transplant: 2 experienced rejection and 2 vasculitis flare. Among the patients with MPA, there was 1 episode of rejection and no vasculitis flare. Whether outcomes following renal transplant may be influenced by the underlying diagnosis of vasculitis merits further study.