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 , Várnai 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=Volume 2 - 2022

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: Cohort study of 7623 patients transplanted between 2005 and 2016 at four major transplant UK centres. Diagnosis of GN in the allograft was extracted from histology reports aided by use of text-mining software. Incidence of the four commonest GN post-transplantation was calculated and risk factors for disease and allograft outcomes were analysed.
Results: 214 patients (2.8%) presented PTGN. IgA Nephropathy (IgAN), Focal segmental glomerulosclerosis (FSGS), Membranous nephropathy (MN) and Membranoproliferative/Mesangiocapillary GN (MPGN/MCGN) were the four commonest 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 than those without in the first 8 years post-transplantation, but results suggest 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 analyse large scale data involving unstructured or complex data points and use of computational analysis can assist.