Related Experiment Video
Updated: May 22, 2025
Mouse Kidney Transplantation: Models of Allograft Rejection
Published on: October 11, 2014
Complement-Mediated Kidney Disease and Living Donor Transplantation: Tailoring Approaches to Improve Outcomes
Aliza Anwar Memon1, Krista L Lentine1,2, Yasar Caliskan1,2
1Division of Nephrology, Department of Medicine, SSM Health Saint Louis University Hospital, St. Louis, MO, USA.
Insights
Evaluating living kidney donors for complement-mediated kidney diseases like aHUS and C3G is evolving. Genetic testing aids risk assessment, but standardized guidance for these complex cases is still needed.
Area of Science:
- Nephrology
- Transplantation Immunology
- Genetics
Background:
- Atypical hemolytic syndrome (aHUS) and C3 glomerulopathy (C3G) are rare complement-mediated diseases.
- These conditions involve excessive alternative complement pathway activation.
- Evaluating living kidney donors for these diseases is complex and evolving.
Purpose of the Study:
- To update the evaluation process for kidney transplant recipients with complement-mediated kidney diseases.
- To assess living donor candidates for these conditions.
- To review current evidence, genetic testing utility, risks, and challenges.
Main Methods:
- Literature review of complement-mediated kidney diseases and living donor transplantation.
- Analysis of emerging evidence and risk assessment tools.
- Focus on genetic testing in donor evaluation.
Main Results:
- Living donor evaluation criteria are changing with new evidence.
- Genetic testing is relevant for identifying variants affecting recurrence risk and donor suitability.
- Limited data exists for guiding living donor evaluation in aHUS and C3G.
Conclusions:
- Kidney transplantation for complement-related disorders requires careful living donor evaluation.
- Further research is needed to optimize risk assessment for living donor candidates.
- Standardized guidance for genetic testing and interpretation is lacking.
Purpose Of Review:
To provide a comprehensive update on the evaluation of kidney transplant recipients with complement-mediated kidney diseases and their living donor (LD) candidates.
Recent Findings:
Atypical hemolytic syndrome (aHUS) and C3 glomerulopathy (C3G) are rare complement-mediated diseases characterized by excessive activation of the alternative complement pathway. The evaluation of living kidney donor candidates for complement-mediated kidney diseases is evolving in response to emerging evidence and advancements in risk assessment tools. Criteria once considered contraindications to living donation are now part of standard practice, while novel genetic markers and risk factors are being identified. For complement-mediated kidney diseases, genetic testing is particularly relevant as it can identify variants that influence disease recurrence risk and donor suitability. Despite these advances, data to guide the evaluation of LD candidates for aHUS and C3G are still very limited. The application and interpretation of novel genetic testing technologies remain in the early stages, and standardized guidance is lacking. In this review, we summarize the approach to LD kidney transplantation for complement-mediated kidney diseases, addressing utility of genetic testing, risks, and ongoing challenges for recipients and LDs.
Summary:
The present review highlights the importance and complexity of kidney transplantation from an LD for patients with complement-related kidney disorders and motivates further research to determine the optimal risk-assessment for LD candidates to recipients with aHUS and C3G.
Related Concept Videos
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:40Cell-mediated Immune Responses