Transplant glomerulopathy | |
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Micrograph showing a glomerulus with changes characteristic of a transplant glomerulopathy. PAS stain. | |
Specialty | Nephrology |
Transplant glomerulopathy (TG) is a morphologic lesion of renal allografts that is histologically identified by glomerular basement membrane (GBM) duplication and/or multilayering.[1] Proteinuria, hypertension, and deteriorating graft function are the hallmarks of TG.[2]
Acute rejection, pre-transplant antibody levels, and de novo HLA antibodies are all linked to TG. There are further risks associated with HLA class II and/or donor-specific antibodies.[2]
Five years after transplant, TG is present in 5–10% of renal allografts; in rare cases, protocol biopsies may reveal TG as a subclinical finding. With chronic alloantibody-mediated injury, the lesion is particularly associated with a poor prognosis for the outcome of the graft.[3]
Importance of Ultrastructural Examination
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