RECURRENT TYPE-I MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS AFTER RENAL-TRANSPLANTATION AND PROTECTIVE ROLE OF CYCLOSPORINE IN ACUTE CRESCENTIC TRANSFORMATION

Almost all diseases affecting the native kidney may recur in the trans planted kidney, with one of the most frequent being recurrent glomerul onephritis. Among the glomerulonephritides, membranoproliferative glom erulonephritis (MPGN), immunoglobulin A nephropathy (IgA), and focal-s egmental glomerulosclerosis (FSGS) have the highest rates of recurrenc e. Here we report a patient who, after living-related kidney transplan tation, suffered allograft loss shortly after surgery due to recurrenc e of glomerulonephritis. Two weeks prior to transplant nephrectomy lig ht microscopic examination of the allograft biopsy failed to show glom erulonephritis. Subsequent histopathology of the transplant nephrectom y specimen demonstrated a crescentic form of type I MPGN following wit hdrawal of cyclosporin A (CsA) and intense course of oral steroid ther apy. The entity of recurrent type I MPGN in kidney transplantation is reviewed, and a possible protective role of CsA against rapidly progre ssive crescentic type I MPGN is explored.