Transplantation, immunosuppression and plasmapheresis in Goodpasture's syndrome

Renal transplantation in the face of circulating anti-glomerular basement membrane (GBM) antibody can lead to recurrent glomerulonephritis. The severity of the recurrence may be related to the level of antibody present at the time of transplantation. We describe a patient with Goodpasture's Syndrome and moderate circulating anti-GBM antibody activity who received a renal transplant, followed by plasmapheresis and immunosuppression. The graft has functioned well for almost two years associated with a continued reduction in levels of circulating anti-GBM antibody.