Regalia Anna, Abinti Matteo, Alfieri Carlo Maria, Campise Mariarosaria, Verdesca Simona, Zanoni Francesca, Castellano Giuseppe
Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Clin Kidney J. 2024 Oct 24;17(12):sfae320. doi: 10.1093/ckj/sfae320. eCollection 2024 Dec.
In recent years, advancements in immunosuppressive medications and post-transplant management have led to a significant decrease in acute rejection rates in renal allografts and consequent improvement in short-term graft survival. In contrast, recent data have shown an increased incidence of post-transplant glomerular diseases, which currently represent a leading cause of allograft loss. Although pathogenesis is not fully understood, growing evidence supports the role of inherited and immunological factors and has identified potential pre- and post-transplant predictors. In this review, we illustrate recent advancements in the pathogenesis of post-transplant glomerular disease and the role of risk factors and immunological triggers. In addition, we discuss potential prevention and management strategies.
近年来,免疫抑制药物和移植后管理方面的进展已导致肾移植急性排斥反应率显著降低,从而使短期移植物存活率得到改善。相比之下,最近的数据显示移植后肾小球疾病的发病率有所增加,目前这是移植物丢失的主要原因。虽然发病机制尚未完全明确,但越来越多的证据支持遗传和免疫因素的作用,并已确定了潜在的移植前和移植后预测因素。在这篇综述中,我们阐述了移植后肾小球疾病发病机制的最新进展以及危险因素和免疫触发因素的作用。此外,我们还讨论了潜在的预防和管理策略。