Kinh Luan THAI, Ngoc Thu Nguyen LA, Tien Dat HOANG, Nguyen Xuong DUONG, Tuan Thanh NGUYEN, Sung SHIN, Tiong Ho YEE, Khac Chuan HOANG, Xuan Thai NGO, Minh Sam THAI
Experimental and Clinical Transplantation - 2026;24(9):699-706
Objectives: We evaluated the clinical characteristics, Oxford 2016 histopathology features, and short-term outcomes of Immunoglobulin A nephropathy in kidney transplant recipients at Cho Ray Hospital, Ho Chi Minh City, Viet Nam. Material and Methods: This retrospective, descriptive study included kidney transplant recipients with biopsy-proven immunoglobulin A nephropathy in kidney allografts identified in 2022. We analyzed patient death with a functioning graft as a competing event and not classified as graft failure. Results: Immunoglobulin A nephropathy was present in 27.1% (19/70) of allograft biopsies. Most recipients were male (73.7%) and received grafts from living related donors (17/19, 89.4%). The mean time from transplant to immunoglobulin A nephropathy diagnosis was 5.2 years. Median follow-up after biopsy was 48 weeks. Three components of the Oxford MEST-C were frequently observed, that is, mesangial hypercellularity M1 (73.7%), segmental glomerulosclerosis S1 (78.9%), and cellular/fibrocellular crescents C1 (26.3%). At the end of follow-up, 68.4% of patients maintained graft function, 15.8% required hemodialysis, and 10.5% died from nonrenal causes with functioning grafts. Conclusions: Immunoglobulin A nephropathy was frequently observed in our patient cohort; however, the inability to distinguish recurrent disease from de novo disease fundamentally limited interpretation of the histopathology patterns. Moreover, given the short-term and multifactorial nature of the outcomes, together with the limitations of the Oxford MEST-C in the allograft setting, the independent prognostic significance of these lesions remains uncertain and requires further validation through larger prospective studies.
