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Related Experiment Videos

IGA nephropathy in HLA-identical siblings

N E Tolkoff-Rubin, A B Cosimi, T Fuller

    Transplantation
    |December 1, 1978
    PubMed
    Summary

    Clinically occult IgA nephropathy was found in a kidney donor, suggesting asymptomatic disease may cause apparent "recurrence" in transplant recipients. This highlights the importance of donor screening for IgA nephropathy.

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    Area of Science:

    • Nephrology
    • Immunology
    • Transplantation

    Background:

    • IgA nephropathy (IgAN) is a common cause of end-stage renal disease.
    • Renal transplantation is a treatment option for end-stage renal disease.
    • Recurrence of IgAN in the allograft is a known complication after kidney transplantation.

    Observation:

    • A patient with end-stage IgAN received a kidney from an HLA-identical sibling.
    • Biopsy of the donor kidney revealed electron-dense mesangial deposits.
    • Immunofluorescence showed IgA staining in these deposits, indicating occult IgAN in the donor.

    Findings:

    • The donor kidney exhibited subclinical IgA nephropathy.
    • This finding suggests that IgAN can be present asymptomatically in healthy donors.

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  • The presence of occult IgAN in the donor kidney challenges the concept of de novo recurrence.

    • Implications:

    • Donor screening for IgAN may be necessary to prevent allograft disease.
    • This case re-evaluates the etiology of IgAN recurrence post-transplant.
    • Understanding donor-to-recipient transmission of IgAN is crucial for improving transplant outcomes.