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Updated: May 22, 2026
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Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Living Donor Kidney Transplantation in High-Recurrence Kidney Diseases: Precision Risk Stratification and Management.
Catherine Verhellen1, Arnaud Devresse1,2,3, Valentine Gillion1,2
1Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Kidney International Reports
|May 21, 2026
Summary
Living-donor kidney transplantation (KT) is effective but disease recurrence can cause graft loss. Advances in biomarkers and therapies improve risk assessment and outcomes for high-risk kidney diseases, optimizing KT success.
Area of Science:
- Nephrology
- Transplantation Immunology
- Genetics
Background:
- Living-donor kidney transplantation (KT) offers superior outcomes for kidney failure (KF).
- Recurrence of primary kidney disease in the transplanted kidney (allograft) is a leading cause of graft loss.
- Risk of recurrence varies significantly by kidney disease, impacting donor and recipient selection.
Purpose of the Study:
- To review the impact of kidney disease recurrence on living-donor KT outcomes.
- To discuss recent advances in biomarkers and therapies for high-risk kidney diseases.
- To highlight the importance of individualized assessment and multidisciplinary evaluation for optimizing KT.
Main Methods:
- Literature review of kidney diseases with varying recurrence risks in KT.
- Analysis of novel biomarkers for risk stratification (e.g., anti-PLA2R, antinephrin antibodies).
- Evaluation of emerging targeted therapies (e.g., complement inhibitors, RNA interference, hematologic therapies).
Main Results:
- Low-to-intermediate risk diseases (lupus nephritis, AAV, IgA nephropathy) are generally safe for living-donor KT with counseling.
- High-risk diseases (MN, FSGS, aHUS, C3G, PH, AL amyloidosis) require complex assessment due to higher recurrence rates.
- Biomarkers and targeted therapies have significantly improved risk stratification and outcomes for specific high-risk conditions.
Conclusions:
- Recent advances are transforming decision-making for living-donor KT in high-risk recurrence settings.
- Multidisciplinary evaluation, individualized strategies, and clear communication are crucial for successful KT.
- Optimizing donor-recipient selection and management strategies enhances long-term graft survival.
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