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Nephrol Dial Transplant. 2010 Dec;25(12):4109-13. doi: 10.1093/ndt/gfq517. Epub 2010 Sep 3.

Successful transplantation of a donor kidney with diffuse proliferative lupus nephritis and crescents--a case report.

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Division of Nephrology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, NY, USA.


Pre-existing diffuse proliferative glomerulonephritis (DPGN) in a potential deceased kidney donor has been considered a contraindication for transplantation. We report a case of a patient who underwent a successful deceased donor renal transplantation from a donor with history of systemic lupus erythematosus (SLE) whose baseline biopsy revealed DPGN. Although the histology was relatively benign in the procurement kidney biopsy done by frozen section, the final light microscopy available after transplantation showed diffuse proliferative lupus nephritis, WHO class IV, with 44% crescents. The post-transplant course was complicated by delayed allograft function requiring haemodialysis for the first week. A repeat biopsy performed after 4 months of transplant showed resolution of the proliferative lesions in the glomeruli with disappearance of the crescents. At 5.5 years of follow-up, the patient's creatinine has been stable at 2.0 mg/dL (176.8 ╬╝mol/L), but he has persistent proteinuria.

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