Q: My cousin is 25 years old and diagnosed with ESRD, IgA nephropathy? Currently he is on dialysis. What is the success rate, if he undergoes a renal transplant? Does he have to be on immunosuppressants for the rest of his life? If he undergoes a transplant, will the disease recur in the new transplanted kidney?

A:IgA nephropathy is the commonest cause of glomerulonephritis, worldwide. Individuals with IgA who have progressed to ESRD do fairly well after receiving renal transplant. Even though the recurrence rate following transplant may vary from 50 to 80%, the loss of kidney transplant because of recurrent IgA is fairly low (<10%). There is a controversy whether IgA patients should receive cadaveric or living related donor kidney since certain studies have indicated that recurrence rate may be lower with cadaveric. But cadaveric donor system in India is non-existent. Certainly, any form of transplantation is superior to remaining on dialysis. Immunosuppression is required for rest of life.