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Re-Evaluating the Transplant Glomerulopathy Lesion—Beyond Donor-Specific Antibodies

Authors :
Arun Chutani
Daniel Guevara-Pineda
Gabriel B. Lerner
Madhav C. Menon
Source :
Transplant International, Vol 37 (2024)
Publication Year :
2024
Publisher :
Frontiers Media S.A., 2024.

Abstract

There have been significant advances in short-term outcomes in renal transplantation. However, longer-term graft survival has improved only minimally. After the first post-transplant year, it has been estimated that chronic allograft damage is responsible for 5% of graft loss per year. Transplant glomerulopathy (TG), a unique morphologic lesion, is reported to accompany progressive chronic allograft dysfunction in many cases. While not constituting a specific etiologic diagnosis, TG is primarily considered as a histologic manifestation of ongoing allo-immune damage from donor-specific anti-HLA alloantibodies (DSA). In this review article, we re-evaluate the existing literature on TG, with particular emphasis on the role of non-HLA-antibodies and complement-mediated injury, cell-mediated immune mechanisms, and early podocyte stress in the pathogenesis of Transplant Glomerulopathy.

Details

Language :
English
ISSN :
14322277
Volume :
37
Database :
Directory of Open Access Journals
Journal :
Transplant International
Publication Type :
Academic Journal
Accession number :
edsdoj.170dd07154b48b1a79583b04f4f11d9
Document Type :
article
Full Text :
https://doi.org/10.3389/ti.2024.13365