Advances in the understanding of complement mediated glomerular disease: implications for recurrence in the transplant setting

Am J Transplant. 2015 Feb;15(2):312-9. doi: 10.1111/ajt.13042.

Abstract

Recent advances in the understanding of the role of complement in glomerular disease allow for more accurate assessment of the risk of disease recurrence after transplantation, and inform the development of targeted treatment strategies to overcome specific defects in the alternate pathway of the complement system. These advances along with remaining knowledge deficits are reviewed with specific relevance to membranoproliferative glomerulonephritis (MPGN) and C3 glomerulopathy, a heterogenous group of diseases with a high rate of recurrence leading to allograft failure. Recommendations to establish an accurate diagnosis and inform therapeutic decision making in transplant candidates with a histologic diagnosis of MPGN are provided.

Keywords: biopsy; clinical research/practice; complement biology; glomerular biology and disease; immunobiology; kidney transplantation/nephrology; pathology/histopathology; recurrent disease.

Publication types

  • Editorial
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Complement System Proteins / physiology*
  • Glomerulonephritis, Membranoproliferative / physiopathology*
  • Humans
  • Kidney Transplantation*
  • Recurrence
  • Risk Factors

Substances

  • Complement System Proteins