Figure 171

Many diseases can recur in transplanted kidneys, although fewer cause graft failure. Those disorders that can cause loss of allografts include oxalosis (primary hyperoxaluria) and some glomerulonephritides, particularly mesangiocapillary glomerulonephritis (MCGN), focal segmental glomerulosclerosis, and sometimes hemolytic uremic syndrome. Diabetes recurs almost universally in isolated renal grafts but rarely causes graft failure. Histologic recurrence of diabetic vascular pathology and glomerular pathology is much more infrequent in patients receiving combined pancreas and kidney transplantations [10,11]. Hepatitis C virus is now recognized as a cause of a number of problems after transplantation, including an increased risk of recurrent and de novo glomerulonephritis (MCGN and membranous) and allograft glomerulopathy [12].

De novo glomerulonephritis Transplanted glomerulonephritis Chronic rejection Acute allograft glomerulopathy Chronic allograft glomerulopathy Cyclosporine toxicity Acute rejection Allograft ischemia Cytomegalovirus infection

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