ANCA Vasculitis Transplant Eligibility — ESENeph MCQ

Correct answer: B — Proceed with transplant assessment despite persistent ANCA positivity

The best answer is “Proceed with transplant assessment despite persistent ANCA positivity”. KDIGO advises delaying kidney transplantation until complete clinical remission has lasted at least 6 months, while persistent ANCA should not delay the procedure. This patient has met the clinical-remission interval. “Delay transplantation until ANCA becomes undetectable” is less appropriate because KDIGO states that persistent ANCA by itself should not defer transplantation “Require 24 months of remission before transplant listing” is less appropriate because the current KDIGO practice point specifies at least 6 months of complete clinical remission “Exclude transplantation because ANCA-associated vasculitis will inevitably recur” is less appropriate because recurrence can occur but AAV is not a contraindication after adequate remission “Restrict transplantation to a living donor” is less appropriate because donor type is not the eligibility condition tested by the remission practice point

Reference: KDIGO 2024 ANCA-associated vasculitis guideline: https://kdigo.org/wp-content/uploads/2024/02/KDIGO-2024-ANCA-Vasculitis-Guideline.pdf