Figure 1726

Most studies have shown that histologic recurrence of Henoch-Schonlein purpura (HSP) is common but rarely causes graft loss. Grafts from living related donors have a substantially increased risk of failure as a result of recurrent HSP. Patients can develop both renal and extrarenal manifestations of HSP, especially arthral-gia. Rapid evolution of the original disease and older age at presentation (>14 y) seem to be risk factors for clinical recurrence. Cyclosporine does not prevent recurrence. It has been arbitrarily suggested that transplantation should be avoided for 12 months after resolution of the purpura; however, individual cases of recurrent disease have been reported despite delays of over 3 years between resolution of purpura and grafting.

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