Corresponding author: Kazuho Honda, Department of Pathology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Tel.: +81 3 3353 8111 ext. 22342; fax: +81 3 5269 7473;
e-mail: [email protected]

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Abstract

Honda K, Horita S, Toki D, Taneda S, Nitta K, Hattori M, Tanabe K, Teraoka S, Oda H, Yamaguchi Y. De novo membranous nephropathy and antibody-mediated rejection in transplanted kidney.
Clin Transplant 2011: 25: 191–200. © 2010 John Wiley & Sons A/S.

Abstract: Background: The etiology of de novo membranous nephropathy (MN) after kidney transplantation is still uncertain. Immunological response to various allograft antigens is speculated to be a candidate for the etiology.

Methods: Seventeen patients with post-transplant de novo MN were studied clinically and pathologically in comparison with control post-transplant patients without MN. Double immunofluorescent staining was performed to identify the presence of donor-specific human leukocyte antigen (HLA) combined with IgG in the deposits on glomerular capillary walls.

Results: De novo MN occurs in relatively late period after transplantation (102.1 ± 68.3 months), presenting various degree of proteinuria. Histological findings associated with antibody-mediated rejection (AMR), such as peritubular capillaritis and C4d deposition in peritubular capillary, were more frequently observed in the patients with de novo MN than the non-MN control patients. Donor-specific antibody (DSA) was detected in five patients at the time of biopsy. In one case of de novo MN with DSA, a donor-derived HLA was identified in the subepithelial deposits on the glomerular capillary walls combined with IgG deposition.

Conclusions: DSA and AMR might play some roles for the pathogenesis in some patients with de novo MN after kidney transplantation.

References

1 Habib R, Antignac C, Hinglais N, Gagnadoux MF, Broyer M. Glomerular lesions in the transplanted kidney in children. Am J Kidney Dis 1987: 10: 198.
10.1016/S0272-6386(87)80175-0
CAS PubMed Web of Science® Google Scholar
2 Schwarz A, Krause PH, Offermann G, Keller F. Recurrent and de novo renal disease after kidney transplantation with or without cyclosporine A. Am J Kidney Dis 1991: 17: 524.
10.1016/S0272-6386(12)80493-8
PubMed Web of Science® Google Scholar
3 Schwarz A, Krause PH, Offermann G, Keller F. Impact of de novo membranous glomerulonephritis on the clinical course after kidney transplantation. Transplantation 1994: 58: 650.
10.1097/00007890-199409270-00002
CAS PubMed Web of Science® Google Scholar
4 Monga G, Mazzucco G, Basolo B et al. Membranous glomerulonephritis (MGN) in transplanted kidneys: morphologic investigation on 256 renal allografts. Mod Pathol 1993: 6: 249.
CAS PubMed Web of Science® Google Scholar
5 Morales JM, Pascual-Capdevila J, Campistol JM et al. Membranous glomerulonephritis associated with hepatitis C virus infection in renal transplant patients. Transplantation 1997: 63: 1634.
10.1097/00007890-199706150-00017
PubMed Web of Science® Google Scholar
6 Ozdemir BH, Ozdemir FN, Sezer S, Colak T, Haberal M. De novo glomerulonephritis in renal allografts with hepatitis C virus infection. Transplant Proc 2006: 38: 492.
10.1016/j.transproceed.2005.12.109
CAS PubMed Web of Science® Google Scholar
7 Truong L, Gelfand J, D’Agati V et al. De novo membranous glomerulonephropathy in renal allografts: a report of ten cases and review of the literature. Am J Kidney Dis 1989: 14: 131.
10.1016/S0272-6386(89)80189-1
CAS PubMed Web of Science® Google Scholar
8 Hiesse C, Goldschmidt E, Santelli G, Charpentier B, Machover D, Fries D. Membranous nephropathy in a bone marrow transplant recipient. Am J Kidney Dis 1988: 11: 188.
10.1016/S0272-6386(88)80211-7
PubMed Web of Science® Google Scholar
9 Barbara JA, Thomas AC, Smith PS, Gillis D, Ho JO, Woodroffe AJ. Membranous nephropathy with graft-versus-host disease in a bone marrow transplant recipient. Clin Nephrol 1992: 37: 115.
PubMed Web of Science® Google Scholar
10 Imai H, Oyama Y, Miura AB, Endoh M, Sakai H. Hematopoietic cell transplantation-related nephropathy in Japan. Am J Kidney Dis 2000: 36: 474.
10.1053/ajkd.2000.9787
CAS PubMed Web of Science® Google Scholar
11 Lin J, Markowitz GS, Nicolaides M et al. Membranous glomerulopathy associated with graft-versus-host disease following allogeneic stem cell transplantation. Report of 2 cases and review of the literature. Am J Nephrol 2001: 21: 351.
10.1159/000046273
CAS PubMed Web of Science® Google Scholar
12 Colombo AA, Rusconi C, Esposito C et al. Nephrotic syndrome after allogeneic hematopoietic stem cell transplantation as a late complication of chronic graft-versus-host disease. Transplantation 2006: 81: 1087.
10.1097/01.tp.0000209496.26639.cb
PubMed Web of Science® Google Scholar
13 El Kossi M, Harmer A, Goodwin J et al. De novo membranous nephropathy associated with donor-specific alloantibody. Clin Transplant 2008: 22: 124.
10.1111/j.1399-0012.2007.00741.x
CAS PubMed Web of Science® Google Scholar
14 Solez K, Axelsen RA, Benediktsson H et al. International standardization of criteria for the histologic diagnosis of renal allograft rejection: the Banff working classification of kidney transplant pathology. Kidney Int 1993: 44: 411.
10.1038/ki.1993.259
CAS PubMed Web of Science® Google Scholar
15 Racusen LC, Colvin RB, Solez K et al. Antibody-mediated rejection criteria: an addition to the Banff 97 classification of renal allograft rejection. Am J Transplant 2003: 3: 708.
10.1034/j.1600-6143.2003.00072.x
PubMed Web of Science® Google Scholar
16 Solez K, Colvin RB, Racusen LC et al. Banff ‘05 Meeting Report: differential diagnosis of chronic allograft injury and elimination of chronic allograft nephropathy (‘CAN’). Am J Transplant 2007: 7: 518.
10.1111/j.1600-6143.2006.01688.x
CAS PubMed Web of Science® Google Scholar
17 Ehrenreich T, Churg J. Pathology of membranous nephropathy. Pathol Annu 1968: 3: 145.
Google Scholar
18 Feucht HE, Schneeberger H, Hillebrand G et al. Capillary deposition of C4d complement fragment and early renal graft loss. Kidney Int 1993: 43: 1333.
10.1038/ki.1993.187
CAS PubMed Web of Science® Google Scholar
19 Collins AB, Schneeberger EE, Pascual MA et al. Complement activation in acute humoral renal allograft rejection: diagnostic significance of C4d deposits in peritubular capillaries. J Am Soc Nephrol 1999: 10: 2208.
10.1681/ASN.V10102208
CAS PubMed Web of Science® Google Scholar
20 Nickeleit V, Andreoni K. The classification and treatment of antibody-mediated renal allograft injury: where do we stand? Kidney Int 2007: 71: 7.
10.1038/sj.ki.5002003
CAS PubMed Web of Science® Google Scholar
21 Colvin RB. Antibody-mediated renal allograft rejection: diagnosis and pathogenesis. J Am Soc Nephrol 2007: 18: 1046.
10.1681/ASN.2007010073
CAS PubMed Web of Science® Google Scholar
22 Aita K, Yamaguchi Y, Horita S et al. Thickening of the peritubular capillary basement membrane is a useful diagnostic marker of chronic rejection in renal allografts. Am J Transplant 2007: 7: 923.
10.1111/j.1600-6143.2006.01708.x
CAS PubMed Web of Science® Google Scholar
23 Colvin RB, Nickeleit V. Acute antibody-mediated rejection. Etiology and pathogenesis. In: JC Jennette, JL Olsen, MM Schwartz, FG Silva, eds. Heptinstall’s Pathology of the Kidney, 6th edn. Volume II. Tokyo: Lippincott Williams & Wilkins, 2007: 1387.
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Volume25, Issue2

March/April 2011

Pages 191-200

De novo membranous nephropathy and antibody-mediated rejection in transplanted kidney

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De novo membranous nephropathy and antibody-mediated rejection in transplanted kidney

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