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Transplant Proc. 2012 Nov;44(9):2599-600. doi: 10.1016/j.transproceed.2012.09.068.

Transplant glomerulopathy: clinical course and factors relating to graft survival.

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1
Nephrology Department, H.U. Carlos Haya, Malaga, Spain. verolopezjim@yahoo.es

Abstract

INTRODUCTION:

Transplant glomerulopathy (TG) is usually associated with a poor prognosis for kidney graft survival.

AIM AND METHODS:

We analyzed 30 cases of TG diagnosed by kidney biopsy among a retrospective review of 579 biopsies performed between January 2006 and October 2011.

RESULTS:

At the time of biopsy, the mean glomerular filtration rate (GFR), estimated by the abbreviated Modification of Diet in Renal Disease was 31 ± 10 mL/min and the proteinuria, 1.9 ± 2 gr/24 hours. Anti-human leukocyte antigen (HLA) antibodies were present in 40% of patients. The histological findings showed severe duplication of the glomerular basement membrane in 80% of patients; and interstitial fibrosis and tubular atrophy (IFTA) and moderate to severe arteriolar hyalinosis in 53% and 56% respectively. Fourteen patients lost their grafts. Graft survival was significantly associated with IFTA (P = .03) and renal function at the time of diagnosis (P = .03).

CONCLUSIONS:

TG was associated with a worse prognosis for the graft among kidney transplant patients. It is often associated with the presence of anti-HLA antibodies. Renal function at the time of diagnosis and IFTA were predictive factors for graft survival in these patients.

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