[A morphologic study of 103 kidneys donated for renal transplantation]

Samples from 103 kidneys donated for transplant were studied under light microscopy (LM), electron microscopy (EM) and immunofluorescence (IM, with C3, C4, C1q, IgG, IgA, IGE, IgM and antifibrin) just before transplantation. Seven kidneys were obtained from a cadaver (CK). Glomerular damage attributed to perfusion (perfusion glomerulopathy) was present in 4 cases. Glomerular changes in apparently healthy donors were present in 33% of cases: minor glomerular lesions, such as type I collagen fibers in the mesangial matrix (3 cases); uniform widening of the basal membrane without prior evidence of diabetes (4); relative glomerular ischemia with basal membrane irregularities (9). Major lesions were found in 17.5% of kidneys: IgA mesangial deposits compatible with Berger's disease (9, including 2 pairs of siblings); dense mesangial deposits suggesting the same process (6); subacute bacterial endocarditis glomerulopathy with IgG++, C1q+ and IgM+ (1, a CK); a type I mesangio-capillary glomerulonephritis with C3++, IgG++, IgA+ and IgM+ (1); subpedicelar and transmembranous isolated glomerular deposits of the immune complex type (1, complicated with microhematuria after donation). None of these glomerulopathies was demonstrated by LM, hence the use of EM and IM is essential for diagnosis.