Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Transplantation. 2018 Apr;102(4):e180-e184. doi: 10.1097/TP.0000000000002089.
Thin basement membrane nephropathy (TBMN) is the most common cause of persistent glomerular hematuria. Most individuals with TBMN show a benign course, although it can be difficult to distinguish it from early stages of progressive renal diseases. However, only limited studies address the prognosis of donors with TBMN and their recipients.
From 2007 to 2016, 11 recipients received kidney grafts from donors with TBMN, and their clinical data were analyzed retrospectively. Follow-up protocol kidney biopsies were given to the recipients at 10 days and 1 year after transplantation. The donors were also received a follow-up evaluation of their renal function and were interviewed via telephone survey.
All donors were living, and their kidney grafts showed TBMN on pretransplantation biopsy. The recipients were followed for 57.4 ± 28.6 months posttransplantation. Seven recipients showed acute rejection by a median of 9.7 months, and all recipients recovered their renal function after treatment. Although 1 kidney failed due to graft arterial occlusion, the functions of the others were preserved during the follow-up period. The donors were followed for 41.0 ± 39.1 months and additionally contacted via telephone survey (in total, 56.8 ± 32.0 months). All the donors maintained their renal function upon clinical follow-up without significant complications and denied any discomfort at the time of the telephone interview.
Kidney transplant donors with TBMN and their recipients maintained their renal function through midterm follow-up without significant complications. Therefore, kidney transplantation from donors with TBMN could be a safe option.
薄基底膜肾病(TBMN)是持续性肾小球性血尿最常见的原因。大多数 TBMN 患者表现为良性病程,尽管很难将其与进展性肾病的早期阶段区分开来。然而,只有有限的研究涉及 TBMN 供体及其受者的预后。
2007 年至 2016 年,11 例受体接受了 TBMN 供体的肾移植,回顾性分析其临床资料。移植后 10 天和 1 年对受体进行了随访方案肾活检。对供体也进行了肾功能的随访评估,并通过电话调查进行了访谈。
所有供体均存活,其移植前活检显示 TBMN。受体移植后随访 57.4±28.6 个月。7 例受体在中位数为 9.7 个月时发生急性排斥反应,所有受体在治疗后均恢复了肾功能。尽管 1 例因移植肾动脉闭塞导致 1 例肾失功,但在随访期间其余肾的功能均得以保留。供体随访 41.0±39.1 个月,并通过电话调查进行了额外的联系(总计 56.8±32.0 个月)。所有供体在临床随访中均保持肾功能,无明显并发症,在电话访谈时否认有任何不适。
TBMN 供体及其受体在中期随访中保持了肾功能,没有明显的并发症。因此,TBMN 供体的肾移植可能是一种安全的选择。