Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Membranous Nephropathy (MN) is a type of glomerulonephritis characterized by thickening of the glomerular basement membrane with immunoglobulin deposition. Proteinuria is a primary symptom, and the condition may sometimes present as nephrotic syndrome. MN is usually diagnosed by a renal biopsy. Therefore, without symptoms, such as proteinuria, hematuria or renal dysfunction, MN is rarely suspected.
Apart from idiopathic MN, secondary MN has also been reported, especially in approximately 5% of cases of primary renal malignancies. Therefore, differential diagnosis of regular follow-up of MN is important. Here we describe 12 cases of MN of donor origin that were accidentally detected by 0-h renal biopsy, which is routinely performed at the time of kidney transplantion in our hospital.
During the period between January 1995 and November 2014, 12 cases of MN of donor origin were accidentally detected (11 living kidney donors and 1 deceased kidney donor) by 0-h renal biopsy during kidney transplantation.
All cases were diagnosed with MN by the histopathological analysis of the 0-h renal biopsy specimen. MN view was disappeared in 7 recipients by transplanted renal biopsy at 1035.1 ± 776.2 days after transplantation. Three donors have past histories such as hepatitis B past infection, prostatic cancer, or the internal past taking of thiamazole, all of which are well known causes of secondary MN. In the pre-transplantation evaluation, two donors had hematuria, however, all donors were negative for proteinuria and had normal kidney function (serum Cr 0.78 ± 0.20mg/dl, eGFR 78.9 ± 17.2ml/min/1.73m2). After follow-up of 972.3 ± 916.5 days after operation, significant proteinuria, hematuria and decreased kidney function (serum Cre 1.17 ± 0.44mg/dl, eGFR 50.0 ± 20.0 ml/min/1.73m2) were not observed. In terms of maliginancies, one donor had undergone a prostatectomy for prostatic cancer before transplantation. On follow-up after transplantation, he was detected to have increasing PSA levels and underwent radical therapy.
Among cases of MN of the donated kidney accidentally detected in the 0-h renal biopsy, several donors did not have symptoms such as proteinuria and hematuria. However, we believe that follow-up of such cases is very important.
To cite this abstract in AMA style:Unagami K, Toki D, Okumi M, Ishigooka H, Tsujimura K, Kanzawa T, Omoto K, Ishida H, Nitta K, Tanabe K. An Investigation of 12 Cases of Membranous Nephropathy of the Donor Origin Accidentally Detected by 0-h Renal Biopsy During Kidney Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/an-investigation-of-12-cases-of-membranous-nephropathy-of-the-donor-origin-accidentally-detected-by-0-h-renal-biopsy-during-kidney-transplantation/. Accessed April 18, 2019.
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