Y Pirson, J Ghysen, J P Cosyns, J P Squifflet, G P Alexandre, C van Ypersele de Strihou
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Aetiology and prognosis of de novo graft membranous nephropathy.
In order to investigate the aetiology and prognosis of de novo graft membranous nephropathy (DNGMN), we review 25 such cases observed among 1258 grafts. Coexistence of chronic rejection lesions and their parallel progression with DNGMN suggest that DNGMN may be part of the rejection process. DNGMN developed in 12 per cent of HLA-identical living donor recipients vs only two per cent of both haplo-identical and cadaver donor recipients; in the latter group, all DNGMN patients had less than or equal to 2 HLA-AB mismatches. Graft survival after diagnosis of DNGMN is only 49 per cent at five years. We conclude that DNGMN is associated with chronic rejection, develops preferentially in well-matched grafts and carries a rather poor prognosis.
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