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Glomerular changes in renal allografts.

J R Manaligod, W Jao, M F Mozes

    American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
    |January 1, 1986
    PubMed
    Summary
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    Renal allograft rejection involves diverse glomerular injuries, including necrosis and inflammation. These changes, particularly heavy proteinuria-associated basal lamina alterations, predict graft failure.

    Area of Science:

    • Nephrology
    • Transplantation Immunology
    • Pathology

    Background:

    • Renal allografts are susceptible to various structural injuries affecting all components.
    • Glomeruli exhibit diverse responses to injury, impacting graft survival.

    Purpose of the Study:

    • To review the patterns of glomerular injury in renal allografts.
    • To correlate specific glomerular changes with clinical outcomes and rejection types.

    Main Methods:

    • Review of pathological findings in renal allografts.
    • Correlation of histological patterns with clinical data on rejection and graft survival.

    Main Results:

    • Recognized patterns include hyperacute/accelerated rejection (fibrinoid necrosis, thrombosis) and de novo/recurrent glomerulonephritis.

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  • Mesangial expansion, arterial changes leading to ischemia, and glomerulitis are observed.
  • Heavy proteinuria is linked to basal lamina alterations (thickening, interposition, lamellation).

    • Conclusions:

    • Diverse glomerular injury patterns are present in renal allografts.
    • Specific histological changes, especially those associated with heavy proteinuria, are indicative of graft failure.