Complement-Mediated Kidney Disease and Living Donor Transplantation: Tailoring Approaches to Improve Outcomes.

IF 2.4 Q2 SURGERY

Current Transplantation Reports Pub Date : 2025-01-01 Epub Date: 2025-04-16 DOI:10.1007/s40472-025-00466-8

Aliza Anwar Memon, Krista L Lentine, Yasar Caliskan

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引用次数: 0

Abstract

Purpose of review: To provide a comprehensive update on the evaluation of kidney transplant recipients with complement-mediated kidney diseases and their living donor (LD) candidates.

Recent findings: Atypical hemolytic syndrome (aHUS) and C3 glomerulopathy (C3G) are rare complement-mediated diseases characterized by excessive activation of the alternative complement pathway. The evaluation of living kidney donor candidates for complement-mediated kidney diseases is evolving in response to emerging evidence and advancements in risk assessment tools. Criteria once considered contraindications to living donation are now part of standard practice, while novel genetic markers and risk factors are being identified. For complement-mediated kidney diseases, genetic testing is particularly relevant as it can identify variants that influence disease recurrence risk and donor suitability. Despite these advances, data to guide the evaluation of LD candidates for aHUS and C3G are still very limited. The application and interpretation of novel genetic testing technologies remain in the early stages, and standardized guidance is lacking. In this review, we summarize the approach to LD kidney transplantation for complement-mediated kidney diseases, addressing utility of genetic testing, risks, and ongoing challenges for recipients and LDs.

Summary: The present review highlights the importance and complexity of kidney transplantation from an LD for patients with complement-related kidney disorders and motivates further research to determine the optimal risk-assessment for LD candidates to recipients with aHUS and C3G.

查看原文本刊更多论文

补体介导的肾脏疾病和活体供体移植：改善预后的定制方法。

综述的目的：提供对补体介导肾病肾移植受者及其活体供体（LD）候选人评价的全面更新。最近发现：非典型溶血综合征（aHUS）和C3肾小球病（C3G）是罕见的补体介导的疾病，其特征是补体替代途径过度激活。随着新出现的证据和风险评估工具的进步，补体介导肾病的活体肾脏候选供体的评估正在不断发展。曾经被认为是活体捐赠禁忌症的标准现在是标准做法的一部分，同时新的遗传标记和风险因素正在被确定。对于补体介导的肾脏疾病，基因检测尤其重要，因为它可以识别影响疾病复发风险和供体适宜性的变异。尽管取得了这些进展，但指导aHUS和C3G的LD候选物评估的数据仍然非常有限。新的基因检测技术的应用和解释仍处于早期阶段，缺乏标准化的指导。在这篇综述中，我们总结了补体介导肾病的LD肾移植方法，解决了基因检测的应用、风险和受体和LD的持续挑战。摘要：本综述强调了补体相关肾脏疾病患者LD肾移植的重要性和复杂性，并推动了进一步的研究，以确定aHUS和C3G患者LD候选人的最佳风险评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Transplantation Reports Medicine-Surgery

CiteScore

3.40

自引率

4.80%

发文量

期刊介绍： Under the guidance of Dr. Dorry Segev, from Johns Hopkins, Current Transplantation Reports will provide an in-depth review of topics covering kidney, liver, and pancreatic transplantation in addition to immunology and composite allografts.We accomplish this aim by inviting international authorities to contribute review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. By providing clear, insightful balanced contributions, the journal intends to serve those involved in the field of transplantation.