Journal
CLINICAL TRANSPLANTATION
Volume 22, Issue -, Pages 76-79Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1399-0012.2008.00855.x
Keywords
kidney transplantation; membranous nephropathy; protocol biopsy
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Live kidney donors are supposed to have no clinical kidney disease. Here, we present a unique case of subclinical membranous nephropathy (MN) from a living donor, who had urinalysis-free stable kidney function pre- and post-transplant. A 39-yr-old Asian woman received a second kidney graft from her spouse whose urinalysis and blood chemistry were stable and normal. Her intraoperative one-h core biopsy revealed thick glomerular basement membrane (GBM) and a bubbly type appearance, compatible with stage II MN on Churg's classification. According to two other protocol biopsies, GBM thickening persisted until month six post-transplant. Interestingly, both the donor and the recipient had stable kidney function without overt proteinuria at each monthly visit until one yr post-transplant. Taken together, we speculate that silent MN may exist in certain healthy individuals, who present only with histopathologically compatible MN and no other findings.
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