Kidney transplant case. Niels Marcussen Hans Dieperink Odense University Hospital. Risc factors for the graft. Male_1961. Nephrotic syndrome 2004 MGUS Membranoproliferative glomerulonephritis, with kappa-chains deposits Peritoneal dialysis 2006 Renal transplant 16SEP2008
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Odense University Hospital
13.5% of biopsies from the first 90 d postTx.
Characterized by mononuclear cell infiltration of the glomerulus
Both monocytes and T cells may be present
The Banff 97 working classification
g0: No glomerulitis
g1: Glomerulitis in less than 25% of glomeruli
g2: Segmental or global glomerulitis in 25% to 75% of glomeruli
g3: Glomerulitis (mostly global) in more than 75% of glomeruli
Recurrent or denovo glomerulonephritis
Chronic transplant glomerulopathy
Glomerular inflammatory cells Monocytes vs. T cells:
Mean monocytes/glomerulus >1 independently predicted poor renal functionat 2 years (Tinckam KJ et al. Kidney Int 68:1866-1874, 2005)
Monocytes is present together with C4d deposition, unlike T cells which are mainly present i cases without C4d deposition (Magil AB, Am J Kidney Dis 45:1084-1089, 2005)