Renal transplantation

• Anti-neutrophil cytoplasmic antibody (ANCA)associated systemic vasculitis (AASV) is not a contraindication to renal transplantation. Despite the risk of disease recurrence post-transplantation, patient and graft outcomes in AASV are similar to those of renal transplant recipients with other causes of renal failure. • The optimal timing for renal transplantation in patients with AASV has not been determined, but it is recommended that clinical remission is achieved prior to undertaking transplantation. • The decision to undertake renal transplantation and the timing of transplantation in patients with AASV should not be guided by levels of ANCA alone. • Standard transplantation immunosuppression regimens for patients with AASV are appropriate. • The diagnosis of disease relapse after renal transplantation should not be based on ANCA monitoring alone, as is the case for AASV in the non-transplant population. • Cyclophosphamide and high-dose corticosteroids can be used to treat relapses that occur in AASV patients post-renal transplantation.