Recurent and de novo membranous glomerulopathy after kidney transplantation

Transplant Proc. 2009 Mar;41(2):669-71. doi: 10.1016/j.transproceed.2009.01.042.

Abstract

The aim of this study was to compare the clinical characteristics of recurrent and de novo membranous glomerulopathy (MG) among a cohort of 614 recipients transplanted between 1989 and 2006. Lupus nephritides were excluded. The diagnosis was established on protocol biopsies performed 1, 2, 4, or 8 years after transplantation or because of proteinuria/nephrotic syndrome and/or an increased serum creatinine level. HCV infection, cryoglobulinemia, monoclonal gammopathy, skin cancers, Kaposi sarcoma, diabetes mellitus, anti-HLA antibodies, and graft survival were not significantly different between the groups. Seventeen MG were diagnosed in 15 patients (2.45% of the whole group), including 6 recurrent MG (35%) and 11 de novo MG (75%). Recurrent MG occurred earlier than de novo MG (15.58 +/- 19.13 vs 49.27 +/- 32.71 months). Recipients with de novo MG were more frequently infected with HCV, which seemed to be the main etiologic factor for de novo MG, and may be linked to a Th2 polarization of the immune response.

MeSH terms

  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Glomerulonephritis, Membranous / epidemiology*
  • Graft Survival
  • Hepatitis C / complications
  • Hepatitis C / epidemiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Male
  • Recurrence
  • Reverse Transcriptase Polymerase Chain Reaction
  • Time Factors

Substances

  • Immunosuppressive Agents