Purpose

Thin basement membrane nephropathy (TBMN) is the most common cause of persistent glomerular hematuria. Most individuals with TBMN shows benign course, but it is hard to distinguish from what is secondary change of progressive renal diseases. Therefore, when the graft kidney appears TBMN in kidney transplantation, it is important to both recipient and donor. However, there are few studies addressing the prognosis of donor and recipient from TBMN kidney donor.

Methods

From 2007 to 2014, 10 recipients have received kidney graft from donor who was diagnosed to have thinner basement membrane than 250 nm at pre-transplant donor biopsy. The data has been collected in the transplant center database and was analyzed with continuing data accumulation.

Results

The recipients were 37.1 ± 17.4 years of age, they were followed up for 1351 ± 851.4 (range, 132 – 2932) days after the transplantation. Their creatinine level was dramatically decreased (p<0.001) from pre-transplantation (9.62 ± 3.94) to post-transplantation 7th day (1.66 ± 1.31), but there was no significant change after then (p=0.547). One implanted kidney showed thin glomerular basement membrane (GBM, 150 – 250 [mu]m) on 0 day biopsy, and two appeared thin GBM at 10th day protocol biopsy. Others showed normal GBM thickness on the protocol biopsy. Four patients appeared acute T cell medicated rejection and one patient showed borderline change at 10th day protocol biopsy. One patient who appeared normal GBM at 0 day biopsy underwent graft failure postoperative 2nd day due to graft arterial occlusion. The donors were 45.9 ± 9.7 years of age, and they were followed up for 855 ± 963.5 (range, 15 – 2904) days after the transplantation. Donor creatinine was increased significantly at postoperative 7th days compared to pre-transplantation (from 0.73 ± 0.12 to 1.08 ± 0.22, p<0.001), but there is no one has been over 1.5 mg/dL and no significant change during the follow-up period (p=0.612).

Conclusion

There is no evidence for decreasing kidney function in the recipient after kidney transplantation from TBMN donor. And it is appeared that the TMMN donor is also safe after kidney donation. However, it is needs to follow up the donor as well as the recipient for longer time.

CITATION INFORMATION: Choi C, Han A, Kim S.-Y, Cho S, Cho M.-J, Lee C, Ahn S, Min S.-K, Ha J, Park M, Kim S, Jung I, Min S.-I. Kidney Transplantation from Thin Basement Membrane Nephropathy Donor. Am J Transplant. 2016;16 (suppl 3).

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