Early renal allograft loss in a patient with crescentic glomerulonephritis in the native kidney

Early recurrence of primary disease after pediatric renal transplantation: two case reports and a review of the literature

Recurrence of primary diseases such as FSGS or HUS is known to cause early graft dysfunction after pediatric renal transplantation. We report the unusual occurrence of early graft dysfunction following kidney transplant in two pediatric cases. Both subjects had biopsy proven recurrence of CGN in less than a week after transplantation. We were able to sustain the renal function in one of them following aggressive treatment. Hence, early recurrence of CGN should be considered in the differential diagnosis of early graft dysfunction.

Preexisting crescentic glomerulonephritis in the renal allograft

Two patients who received cadaveric renal transplants from the same donor were found to have similar diffuse proliferative glomerular lesions on renal biopsies performed for delayed graft function. The donor had no known disease, but had subtle abnormalities on preprocurement urinalysis. In retrospect, lupus nephritis is suspected in the donor. The authors detail the course of these 2 patients, review the literature on preexisting glomerular lesions, and address issues with regard to donor selection.

Recurrence of ANCA-positive glomerulonephritis immediately after renal transplantation

Recurrence of crescentic necrotizing glomerulonephritis after renal transplantation is rare. Successful renal transplantation in patients with antineutrophil cytoplasmic autoantibody (ANCA) glomerulonephritis has been reported. The presence of ANCA at transplantation does not appear to increase the rate of relapse after kidney allografting. Therapy with cyclophosphamide and corticoids usually is effective. We report a case of recurrent perinuclear ANCA crescentic necrotizing glomerulonephritis immediately after renal transplantation that was treated successfully by cyclophosphamide, plasma exchange, and intravenous polyvalent immunoglobulin.