C3 glomerulopathy post kidney transplantation: A single center experience

Figure 1 Recurrence-free survival in C3 glomerulonephritis and dense deposit disease recurrence cases. P = 0.424, log-rank test. C3GN: C3 glomerulonephritis; DDD: Dense deposit disease.

Figure 2 Representative histologic findings of patients with post-transplant recurring C3 glomerulopathies. A: Glomerulus from patient C3 glomerulonephritis-3 (C3GN-3). 4 months post-transplant demonstrating global endocapillary hypercellularity with neutrophil margination (exudative pattern) (Hematoxylin and eosin stain, original magnification 400 ×); B: Glomerulus from patient dense deposit disease-8. 2 months post-transplant demonstrating mild neutrophilic endocapillary hypercellularity and a segmental cellular crescent (arrow) (Periodic acid-Schiff stain, original magnification 400 ×); C: Glomeruli from patient C3GN-1. 38 months post-transplant demonstrating well developed membranoproliferative glomerulonephritis pattern of injury (Jones silver stain, original magnification 400×); D: 4+ global granular to smudgy mesangial and capillary wall immunofluorescence staining with C3 (400 ×); E: Electron micrograph from patient C3GN-1. 12 months post-transplant demonstrating large subepithelial “hump-like” granular deposits (arrows) (original magnification 4000 ×); F: Electron micrograph from patient dense deposit disease-8. 2 months post-transplant demonstrating extensive highly osmiophilic intramembranous fusiform deposits (arrow) (original magnification 2500 ×).

Figure 3 Death censored allograft survival from index biopsy in C3 glomerulopathies recurrence untreated and treated cohorts. The patients in the treatment cohort received steroids (n = 1), eculizumab (n = 4), or eculizumab and plasmapheresis (n = 2). P = 0.003, log-rank test.