Clinical study
Glomerular lesions after renal transplantation

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Abstract

Significant changes in glomeruli on light microscopy has been observed in 27 of 109 cadaveric renal allografts which functioned beyond 6 months. Tissue was available for study from all but two allografts. The histologic lesions were classified as follows: recurrent glomerulonephritis, 9 cases (3 focal sclerosis, 2 mesangial immunoglobulin A [IgA] disease, 2 mesangiocapillary glomerulonephritis, 1 dense deposit disease, 1 familial nephritis); de novo glomerulonephritis, 1 case (diffuse proliferative glomerulonephritis with crescents); and glomerular change of uncertain etiology, 17 cases (10 mesangiocapillary, 5 focal sclerosis, 1 focal proliferative and 1 mesangial proliferative). These lesions were not distinguishable on light, fluorescent and electron microscopy from those in patients with spontaneous renal disease. All patients with glomerular lesions had proteinuria, and all but 3 had microscopic hematuria. Glomerular lesions were not significantly associated with early clinical rejection episodes or HLA compatibility. Presensitization of HLA antigens was significantly related to the occurrence of a nonrecurrent glomerular lesion. Vesicoureteral reflux was significantly more frequent in those with glomerular change (14 of 24) than in those without (13 of 48). Glomerular lesions were associated with a higher rate of graft loss due to renal transplant failure; renal function in survivors was significantly worse than in those without glomerular lesions.

References (23)

  • P Kincaid-Smith

    Histological diagnosis of rejection of renal homografts in man

    Lancet

    (1967)
  • P Kincaid-Smith et al.

    Cadaveric transplantation in man

    Lancet

    (1967)
  • R Habib

    Focal glomerular sclerosis

    Kidney Int

    (1973)
  • K Porter et al.

    Human renal transplants. I. Glomerular changes

    Lab Invest

    (1967)
  • W Rosenav et al.

    A light, fluorescence and electron microscopic study of functioning human renal transplants

    Surg Gynec Obset

    (1969)
  • P Kincaid-Smith

    Pathogenesis of the vascular and glomerular lesions of rejection in renal allografts and their modification by antithrombotic and anticoagulant drugs

    Asian Ann Med

    (1970)
  • TE Starzl et al.

    Long term survival after renal transplantation in humans

    Ann Surg

    (1970)
  • TH Mathew et al.

    Percutaneous needle biopsy of renal homografts

    Med J Aust

    (1968)
  • R Habib

    Classification anatomique des néphropathies glomérulaires

    Päd Fortbildingskurse

    (1970)
  • Kincaid-Smith P: The Kidney—A Clinico-pathological Study, Oxford, Blackwell (in...
  • GS Spear et al.

    Alport's syndrome emphasizing electron microscopic studies of the glomerulus

    Am J Pathol

    (1972)
  • Cited by (0)

    1

    From the Department of Nephrology, Royal Melbourne Hospital; and the Department of Medicine, University of Melbourne, Victoria, Australia.

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