Evaluating a Living Donor With Rheumatoid Arthritis for a Recipient With End-Stage Renal Disease From Antineutrophil Cytoplasmic Antibodies Associated Vasculitis

Luisa M De Souza; Nasrollah Ghahramani; Catherine Abendroth; Gurwant Kaur

doi:10.7759/cureus.18117

Evaluating a Living Donor With Rheumatoid Arthritis for a Recipient With End-Stage Renal Disease From Antineutrophil Cytoplasmic Antibodies Associated Vasculitis

Cureus. 2021 Sep 20;13(9):e18117. doi: 10.7759/cureus.18117. eCollection 2021 Sep.

Authors

Luisa M De Souza¹, Nasrollah Ghahramani², Catherine Abendroth³, Gurwant Kaur²

Affiliations

¹ Medicine, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA.
² Nephrology, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
³ Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Abstract

A 60-year-old Caucasian female with sero-positive rheumatoid arthritis (RA) was evaluated as a potential kidney donor for her brother-in-law with end-stage kidney disease (ESKD) secondary to c-antineutrophil cytoplasmic antibody (c-ANCA) associated vasculitis (AAV) and membranous nephropathy (MN). With little to no data supporting or contradicting this unique scenario, in addition to the varying viewpoints expressed by the different specialists, our multidisciplinary transplant committee encountered a difficult decision of whether to approve a candidate with RA for a living kidney donation or not. As a result, we carried out a careful literature review addressing aspects of recipients' outcomes following kidney transplants from a living donor with RA, especially when the recipient has AAV, living donor's short- and long-term outcomes post kidney donation, renal disease in AAV and RA, and maintenance of disease remission.

Keywords: anca-associated vasculitis; esrd; kidney transplantation; living kidney donor; rheumatoid arthritis.

Publication types

Case Reports