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Glomerular lesions after renal transplantation.
The American Journal of Medicine
|August 1, 1975
Summary
Glomerular lesions affect kidney transplants, impacting graft survival. These changes, including recurrent and de novo glomerulonephritis, are linked to worse renal function and higher graft loss.
Area of Science:
- Nephrology
- Transplantation immunology
- Pathology
Background:
- Glomerular changes can occur in renal allografts functioning long-term.
- Histologic lesions in transplanted kidneys may mimic those seen in native kidney disease.
Purpose of the Study:
- To investigate the incidence, types, and clinical significance of glomerular lesions in cadaveric renal allografts functioning beyond six months.
Main Methods:
- Light microscopy was used to examine glomeruli from 109 cadaveric renal allografts functioning >6 months.
- Histologic lesions were classified, and clinical data including proteinuria, hematuria, rejection episodes, HLA sensitization, and vesicoureteral reflux were analyzed.
Main Results:
- Glomerular lesions were found in 27% of allografts, including recurrent glomerulonephritis, de novo glomerulonephritis, and lesions of uncertain etiology.
- These lesions were associated with proteinuria, microscopic hematuria, and a higher frequency of vesicoureteral reflux.
- Presensitization to HLA antigens correlated with nonrecurrent glomerular lesions, while lesions were linked to increased graft loss and poorer renal function in survivors.
Conclusions:
- Glomerular lesions in renal allografts are common and histologically similar to primary kidney diseases.
- These lesions negatively impact renal transplant outcomes, contributing to graft failure and reduced function.
- HLA presensitization and vesicoureteral reflux are associated factors, highlighting the complexity of graft pathology.