Related Experiment Video
Updated: Jun 27, 2026
A Rat Orthotopic Renal Transplantation Model for Renal Allograft Rejection
Published on: February 2, 2022
[The histological picture of CRF in kidney grafts]
1Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi, Torino, Italy. gianna. mazzucco@unito.it
Abstract:
The most common immunological causes of delayed renal function failure in kidney grafts are recurrent glomerular disease, de novo glomerulonephritis, and chronic cellular or antibody-mediated rejection. Glomerulonephritis can recur any time in the natural history of renal allografts, with the same morphological features of the disease occurring in the native kidney. It has a frequency varying from 100% to 1% and a generally favorable prognosis with the exception of FSGS, SHU and diabetic glomerulosclerosis. The most frequent glomerular diseases to occur de novo in the kidney graft are membranous glomerulopathy, antiglomerular basement membrane disease in patients with Alport's syndrome, and nephrotic syndrome of the Finnish type with antinephrin antibodies in patients with NPHS1 gene mutations. Chronic rejection, including chronic transplant arteriopathy and chronic transplant glomerulopathy, is the cause of renal failure in up to 20% of kidney grafts and may occur as early as a few months after transplant.
Insights
Delayed kidney graft failure is often caused by immunological issues like recurrent or new glomerular disease and chronic rejection. While some glomerular diseases have a good outlook, others and chronic rejection pose significant risks to graft survival.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Context:
- Delayed graft function failure is a critical concern in kidney transplantation.
- Immunological complications are primary drivers of graft dysfunction.
- Understanding these causes is vital for improving long-term graft survival.
Purpose:
- To outline the primary immunological causes of delayed renal function failure in kidney grafts.
- To differentiate between recurrent, de novo glomerular diseases, and chronic rejection.
- To highlight the varying prognoses associated with different conditions.
Summary:
- Common causes include recurrent glomerular disease, de novo glomerulonephritis, and chronic rejection (cellular or antibody-mediated).
- Glomerulonephritis recurrence mirrors native kidney disease, with variable frequency and prognosis, except for FSGS, SHU, and diabetic glomerulosclerosis.
- De novo diseases include membranous glomerulopathy, anti-GBM disease in Alport's syndrome, and Finnish nephrotic syndrome.
- Chronic rejection, encompassing arteriopathy and glomerulopathy, contributes to failure in up to 20% of grafts, potentially occurring early post-transplant.
Impact:
- Informing clinical management strategies for kidney transplant recipients.
- Guiding research towards targeted therapies for specific immunological graft failures.
- Improving patient outcomes and graft longevity through better understanding of disease mechanisms.
