Table 1.
Characteristics and potential etiologies for de novo ICMGN
| ICMGN-NOS (N=21)(a) |
IgAN (N=11)(b) |
MN (N=8)(c) |
HCV (N=4)(d) |
Infection-related (N=2)(e) |
|
|---|---|---|---|---|---|
| Post-transplant interval (years) | 4.2 (2.5, 7.3) | 4.6 (3.1, 8.1) | 3.4 (1.4, 7.8) | 3.3 (2.1, 4.3) | 1.8 and 9 |
| Induction with IL-2R | 8/20 (40%) | 3/11 (27%) | 0/7 (0%) | 4/4 (100%) | 0/2 (0%) |
| Prior solid organ transplant (%) | 6/21 (29%) | 4/11 (36%) | 3/8 (38%) | 1/4 (25%) | 0/2 (0%) |
| AMR | 2/21 (9.5%) | 2/11 (18.2%) | 4/8 (50%) | 1/4 (25%) | 0/2 (0%) |
| DSA without AMR | 4/21 (19%) | 2/11 (18.2%) | 1/8 (12.5%) | 1/4 (25%) | 0/2 (0%) |
| TCMR | 6/21 (28.5%) | 2/11 (18.2%) | 2/8 (25%) | 0/4 (0%) | 1/2 (50%) |
| ANA or other autoantibodies | 1/21 (4.8%) | 0/11 (0%) | 1/8 (12.5%) | 1/4 (25%) | 0/2 (0%) |
| HCV | 0/21 (0%) | 0/11 (0%) | 0/8 (0%) | 4/4(100%) | 0/2 (0%) |
| Infection (non-HCV) | 0/21 (0%) | 0/11 (0%) | 0/8 (0%) | 0/4 (0%) | 2/2 (100%) |
| Others | 1/11 (9%) (cirrhosis) | ||||
| No apparent etiology identified | 11/21 (52.3%) | 5/11 (45.4%) | 3/8 (37.5%) | 0/4 (0%) | 0/2 (0%) |
Abbreviations AMR, antibody-mediated rejection; DSA, circulating donor-specific antibodies; TCMR, T cell mediated rejection
CUIMC patients with de novo ICMGN (n=46, retrospectively identified between 2011-2019)
This study was approved by Columbia Institutional Review Board and published in part previously (reference 131).
In this non-published part of the study, we sought to associate de novo ICMGN with possible etiologies. One of the 21 IGMGN-NOS, was associated with positive ANA and a history of autoimmune hepatitis, and was therefore favored to be related to autoimmunity. One of the 11 patients with de novo IgAN had liver cirrhosis and was classified as IgAN secondary to liver cirrhosis.
- Data on induction therapy was not available for 2 patients (1 with GN-NOS and 1 with MN). Per protocol, all recipients with HCV receive induction therapy with IL2R
- Some patients had more than one potential etiology:
2 patients had TCMR and DSA without AMR. 1 patient had ANA and DSA without AMR.
1 patient had TCMR and DSA without AMR.
1 patient had AMR and TCMR. 1 patient had AMR, TCMR and ANA.
1 patient had HCV and DSA. 1 patient had HCV and AMR. 1 patient had HCV and ANA.
1 patient had infectious etiology and TCMR.