De novo glomerular diseases after renal transplantation: How is it different from recurrent glomerular diseases?

Table 4 The risk of recurrence of de novo glomerulonephritis after retransplantation is unknown

Disease	Indications to retransplant
MN	In view of the slow progression, there is no contraindication to retransplant
MPGN	The risk of recurrence is high in carriers of HCV, active autoimmune disease, or monoclonal gammopathy. These risk factors should be removed or inactivated before retransplant
FSGS	If FSGS was caused by calcineurin inhibitor or mTOR inhibitor toxicity, there is no contraindication to retransplant, but the dosage of the offending drug should be minimized. If FSGS was associated with AMR, the risk of recurrence is increased. Circulating antibodies should be removed before retransplant
Collapsing nephropathy	Risk of recurrence is probably high. Antiviral and/or removal of circulating AB before retransplant are recommended according to the possible role played by virus infection or AMR in the 1st transplant
MCD	In view of the favorable prognosis, there is no contraindication to retransplant
IgAN	No contraindication to retransplant

Adapted from: Ponticelli et al[14] (2014), De Novo Glomerular Diseases after Renal Transplantation. Clin J Am Soc Nephrol 2014; 9: 1479-1487. Published online 2014, with permission. MCD: Minimal change disease; NS: Nephrotic syndrome; MN: Membranous nephropathy; MPGN: Membranoproliferative GN; HCV: Hepatitis C virus; FSGS: Focal segmental glomerulosclerosis.