PReS-FINAL-2322: Outcome of kidney transplantation in paediatric patients with ANCA associated glomerulonephritis: a single-center experience

Results Since 2000 there have been 6 paediatric patients transplanted with ANCA GN (5 MPA). 5 patients were ANCA positive at diagnosis: 1 c-ANCA, PR3 positive and 4 pANCA MPO positive. Age at ANCA GN diagnosis was 10.4 ± 4.3 (Mean ± SD) years (range 4.1 to 15.4). eGFR at diagnosis was 14.1 ± 6.2 ml/min/1.73 m. Renal biopsy category was crescentic in 4 and sclerotic in 2 by the new histopathological classification. Initial treatments included: steroids 6 [100%], cyclophosphamide 4 [66.69%] and PLEX 1 [16.67%]. 2 patients had disease relapse within the first 6 months. 4 patients required dialysis at diagnosis (HD) and remained dialysis dependent. All 6 were dialysis dependent by 6 months post diagnosis. Time from ANCA GN diagnosis to kidney transplant (Mean ± SD) was 31 ± 12 months (range 17 48 months). All patients received induction therapy and maintenance immunosuppression with prednisone, mycophenolate mofetil, and tacrolimus. Median duration of follow up post transplantation was 3.5 years (range 1.25 6.9). eGFR at last follow up was 71.9 ± 34.7 ml/min/1.73 m (range 5.7 100.5). 1 patient lost her transplant to biopsy-proven, severe acute cellular rejection due to complete non-adherence to medications after 21 months of stable transplant function. No patient had recurrence of vasculitis.