AUTHOR=Aguiar Rute , Bourmpaki Elli , Bunce Catey , Coker Bola , Delaney Florence , de Jongh Leonardo , Oliveira Giovani , Weir Alistair , Higgins Finola , Spiridou Anastasia , Hasan Syed , Smith Jonathan , Mulla Abdulrahim , Glampson Ben , Mercuri Luca , Montero Rosa , Hernandez-Fuentes Maria , Roufosse Candice A. , Simmonds Naomi , Clatworthy Menna , McLean Adam , Ploeg Rutger , Davies Jim , VĂ¡rnai Kinga Anna , Woods Kerrie , Lord Graham , Pruthi Rishi , Breen Cormac , Chowdhury Paramit TITLE=Incidence, Risk Factors, and Effect on Allograft Survival of Glomerulonephritis Post-transplantation in a United Kingdom Population: Cohort Study JOURNAL=Frontiers in Nephrology VOLUME=2 YEAR=2022 URL=https://www.frontiersin.org/journals/nephrology/articles/10.3389/fneph.2022.923813 DOI=10.3389/fneph.2022.923813 ISSN=2813-0626 ABSTRACT=Background

Post-transplant glomerulonephritis (PTGN) has been associated with inferior long-term allograft survival, and its incidence varies widely in the literature.

Methods

This is a cohort study of 7,623 patients transplanted between 2005 and 2016 at four major transplant UK centres. The diagnosis of glomerulonephritis (GN) in the allograft was extracted from histology reports aided by the use of text-mining software. The incidence of the four most common GN post-transplantation was calculated, and the risk factors for disease and allograft outcomes were analyzed.

Results

In total, 214 patients (2.8%) presented with PTGN. IgA nephropathy (IgAN), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and membranoproliferative/mesangiocapillary GN (MPGN/MCGN) were the four most common forms of post-transplant GN. Living donation, HLA DR match, mixed race, and other ethnic minority groups were associated with an increased risk of developing a PTGN. Patients with PTGN showed a similar allograft survival to those without in the first 8 years of post-transplantation, but the results suggest that they do less well after that timepoint. IgAN was associated with the best allograft survival and FSGS with the worst allograft survival.

Conclusions

PTGN has an important impact on long-term allograft survival. Significant challenges can be encountered when attempting to analyze large-scale data involving unstructured or complex data points, and the use of computational analysis can assist.