Figure 1727

Both mesangiocapillary glomerulonephritis (MCGN) type I (mesan-gial and subendothelial deposits) and type II (dense deposit disease) commonly recur after transplantation. Silent recurrence is found more often in type II disease, whereas recurrence of type I MCGN frequently causes nephrotic syndrome and graft failure [35]. An increased risk of recurrence of type I MCGN occurs in grafts from living related donors. Type II disease recurs more often in male patients who progressed rapidly to end-stage renal failure before transplantation. The onset of nephrotic syndrome in type II disease usually heralds graft failure. No established treatment for recurrent disease exists, although anecdotally aspirin plus dipyridamole and cyclophosphamide have been used with some success in recurrent type I MCGN. Plasma exchange has been reported to improve the histologic changes and induce a clinical remission in one patient with recurrence of type II MCGN [36].

A cell deposits membrane
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