Aetiology and prognosis of de novo graft membranous nephropathy.

Y Pirson, J Ghysen, J P Cosyns, J P Squifflet, G P Alexandre, C van Ypersele de Strihou
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Abstract

In order to investigate the aetiology and prognosis of de novo graft membranous nephropathy (DNGMN), we review 25 such cases observed among 1258 grafts. Coexistence of chronic rejection lesions and their parallel progression with DNGMN suggest that DNGMN may be part of the rejection process. DNGMN developed in 12 per cent of HLA-identical living donor recipients vs only two per cent of both haplo-identical and cadaver donor recipients; in the latter group, all DNGMN patients had less than or equal to 2 HLA-AB mismatches. Graft survival after diagnosis of DNGMN is only 49 per cent at five years. We conclude that DNGMN is associated with chronic rejection, develops preferentially in well-matched grafts and carries a rather poor prognosis.

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新生移植物膜性肾病的病因及预后。
为了探讨新生移植物膜性肾病(DNGMN)的病因和预后,我们回顾了1258例移植物中观察到的25例此类病例。慢性排斥病变的共存及其与DNGMN的平行进展表明DNGMN可能是排斥过程的一部分。在hla相同的活体供体受者中,12%的人发生DNGMN,而在单倍相同和尸体供体受者中,这一比例仅为2%;在后一组中,所有DNGMN患者的HLA-AB错配小于或等于2。诊断为DNGMN后5年移植物存活率仅为49%。我们得出结论,DNGMN与慢性排斥反应有关,优先发生在匹配良好的移植物中,预后相当差。
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