De Novo Membranous Glomerulonephropathy in Renal Allografts: A Report of Ten Cases and Review of the Literature

Luan Truong, Janice Gelfand, Vivette D'Agati, John Tomaszewski, Gerald Appel, Mark Hardy, Conrad L. Pirani

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

De novo posttransplantation membranous glomerulonephropathy (MGN) is the most common form of de novo glomerulopathy in renal allografts. The clinical and pathological features of ten patients with de novo MGN were studied and the related literature was reviewed to assess the clinical features, morphologic characteristics, and natural course of this disease. De novo MGN may occur in both living related and cadaveric allografts at any time after transplantation. It presents clinically either as asymptomatic proteinuria or the nephrotic syndrome, a feature of poor prognostic implication. Morphologically, de novo MGN in most instances has distinct differences from idiopathic MGN in native kidneys and is accompanied by varying features of rejection. About 50% of grafts which develop de novo MGN eventually fail. This rather poor outcome may not represent the natural history of de novo MGN per se but rather the consequences of associated chronic rejection. Evidence is presented that many of the cases of so-called de novo MGN may be a complication of transplant glomerulopathy rather than being caused by mechanisms totally independent from rejection.

Original languageEnglish (US)
Pages (from-to)131-144
Number of pages14
JournalAmerican Journal of Kidney Diseases
Volume14
Issue number2
DOIs
StatePublished - Jan 1 1989

Keywords

  • De novo membranous glomerulonephropathy
  • subendothelial electronlucent material
  • subepithelial deposits
  • transplant glomerulopathy

ASJC Scopus subject areas

  • Nephrology

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