Recurrence of membranous nephropathy after renal transplantation. Incidence and risk factors in 1614 patients.

The exact incidence of recurrence of membranous nephropathy (MN) after renal transplantation is not well documented because of the limited number of series involving a small number of patients. The aim of this study was to assess the incidence of MN recurrence in our population of renal transplant patients, to identify the risk factors associated with the recurrence, and to analyze the influence of the recurrence on graft and patient survival rates. The recurrence was defined as biopsy-proven MN on the renal graft in a patient whose original disease was MN. Among 1614 consecutive renal transplantations performed from January 1, 1980, to June 1, 1993, the incidence of recurrence was 26.3%, i.e., 5 recurrences out of 19 transplantations. We were unable to show pretransplant epidemiological, immunological, and therapeutic factors associated with recurrence. The HLA DR3 allele was present in 2 patients with recurrence (40%), compared with 3 patients without recurrence (21.4%). The early use of cyclosporine was not associated with a decreased prevalence of MN recurrence. Graft survival was not influenced by the recurrence. Three lymphomas were observed in the 19 transplanted patients with MN as causal nephropathy.