Outcome of Renal Transplantation in Alport's Syndrome: A Single-Center Experience

Background. Anti-glomerular basement membrane (anti-GBM) nephritis post renal transplantation (RTx) is known to cause graft loss in Alport's syndrome (AS). We evaluated the results of RTx in AS patients vis a vis patient and graft survivals, incidence of anti-GBM nephritis, and causes of graft failure. Materials and methods. Between 1993 and 2009 we performed 31 RTx on AS patients (28 males and three females) of overall mean age of 22 +/- 7.9 years from six deceased and 27 living donors. Two patients underwent second RTx. Results. Over a follow-up of 1, 3, 5, and 10 years, the mean serum creatinines (mg/dL) were 1.51 +/- 0.52, 1.59 +/- 0.26, 1.61 +/- 0.30, and 1.63 +/- 0.32, respectively. Patient survivals at 1, 5, and 10 years were 89.71%, 81.32% and 81.32% with graft survival for all periods of 81.2%. Twenty-one percent experienced biopsy-proven acute rejection episodes. Graft failures were due to anti-GBM nephritis in 12.2% (n = 4), chronic allograft nephropathy in 3.2% (n = 1), and acute rejection or cyclosporine toxicity 3.2% (n = 1 each). The mean duration to graft loss was 4.9 +/- 2.4 months. Conclusion. Graft and patient survivals were acceptable among transplant recipients with AS despite the risk of anti-GBM nephritis.