UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Recurrence of C3 glomerulopathies after transplantation

Authors
Anuja Java, MD
Daniel C Brennan, MD, FACP
Section Editor
Barbara Murphy, MB, BAO, BCh, FRCPI
Deputy Editor
Albert Q Lam, MD

INTRODUCTION

Membranoproliferative glomerulonephritis (MPGN, also called mesangiocapillary or lobular glomerulonephritis) is a disease defined by a pattern of glomerular injury observed by light microscopy on renal biopsy.

An MPGN pattern of injury may result from multiple causes including infection, autoimmune diseases, monoclonal gammopathies, and complement dysregulation. MPGN resulting from complement dysregulation is called C3 glomerulopathy.

Patients with C3 glomerulopathy commonly progress to end-stage renal disease (ESRD) and require renal replacement therapy, including dialysis and/or transplantation. Among such patients who undergo transplantation, recurrence is common in the transplanted kidney.

This topic reviews recurrent C3 glomerulopathy in the transplanted kidney. The recurrence in the transplanted kidney of idiopathic MPGN is discussed elsewhere. (See "Recurrence of idiopathic immune complex-mediated membranoproliferative glomerulonephritis (MPGN) after transplantation".)

The presentation, classification, causes, and treatment of MPGN in the native kidney are discussed elsewhere. (See "Clinical presentation, classification, and causes of membranoproliferative glomerulonephritis" and "Evaluation and treatment of membranoproliferative glomerulonephritis" and "C3 glomerulopathies: Dense deposit disease and C3 glomerulonephritis".)

        

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Thu Jan 22 00:00:00 GMT+00:00 2015.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Sethi S, Fervenza FC, Zhang Y, et al. Proliferative glomerulonephritis secondary to dysfunction of the alternative pathway of complement. Clin J Am Soc Nephrol 2011; 6:1009.
  2. Sethi S, Fervenza FC. Membranoproliferative glomerulonephritis: pathogenetic heterogeneity and proposal for a new classification. Semin Nephrol 2011; 31:341.
  3. Rincón B, Bernis C, Garcia A, Traver JA. Mesangiocapillary glomerulonephritis associated with hydatid disease. Nephrol Dial Transplant 1993; 8:783.
  4. Goules A, Masouridi S, Tzioufas AG, et al. Clinically significant and biopsy-documented renal involvement in primary Sjögren syndrome. Medicine (Baltimore) 2000; 79:241.
  5. Denton MD, Singh AK. Recurrent and de novo glomerulonephritis in the renal allograft. Semin Nephrol 2000; 20:164.
  6. Floege J. Recurrent glomerulonephritis following renal transplantation: an update. Nephrol Dial Transplant 2003; 18:1260.
  7. Kotanko P, Pusey CD, Levy JB. Recurrent glomerulonephritis following renal transplantation. Transplantation 1997; 63:1045.
  8. Mathew TH. Recurrence of disease following renal transplantation. Am J Kidney Dis 1988; 12:85.
  9. Cameron JS. Glomerulonephritis in renal transplants. Transplantation 1982; 34:237.
  10. Choy BY, Chan TM, Lai KN. Recurrent glomerulonephritis after kidney transplantation. Am J Transplant 2006; 6:2535.
  11. Habib R, Antignac C, Hinglais N, et al. Glomerular lesions in the transplanted kidney in children. Am J Kidney Dis 1987; 10:198.
  12. Braun MC, Stablein DM, Hamiwka LA, et al. Recurrence of membranoproliferative glomerulonephritis type II in renal allografts: The North American Pediatric Renal Transplant Cooperative Study experience. J Am Soc Nephrol 2005; 16:2225.
  13. Zand L, Lorenz EC, Cosio FG, et al. Clinical findings, pathology, and outcomes of C3GN after kidney transplantation. J Am Soc Nephrol 2014; 25:1110.
  14. Pickering MC, D'Agati VD, Nester CM, et al. C3 glomerulopathy: consensus report. Kidney Int 2013; 84:1079.
  15. Vivarelli M, Emma F. Treatment of C3 glomerulopathy with complement blockers. Semin Thromb Hemost 2014; 40:472.
  16. Bomback AS, Smith RJ, Barile GR, et al. Eculizumab for dense deposit disease and C3 glomerulonephritis. Clin J Am Soc Nephrol 2012; 7:748.
  17. McCaughan JA, O'Rourke DM, Courtney AE. Recurrent dense deposit disease after renal transplantation: an emerging role for complementary therapies. Am J Transplant 2012; 12:1046.
  18. Medjeral-Thomas NR, O'Shaughnessy MM, O'Regan JA, et al. C3 glomerulopathy: clinicopathologic features and predictors of outcome. Clin J Am Soc Nephrol 2014; 9:46.
  19. Java A, Gaut JP, Brennan DC. De novo membranoproliferative glomerulonephritis III in a renal transplant patient: case report and review of the literature. Transpl Int 2012; 25:e58.