jkstn The Journal of the Korean Society for Transplantation J Korean Soc Transplant 1598-1711 The Korean Society for Transplantation 10.4285/jkstn.2011.25.2.71 jkstn-25-71 Review Article Pathogenesis of Transplant Glomerulopathy LimBeom JinM.D. JeongHyeon JooM.D. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea 책임저자：정현주, 서울시 서대문구 신촌동 134 연세대학교 의과대학 병리학교실, 120-752 Tel: 02-2228-1766, Fax: 02-362-0860 E-mail: jeong10@yuhs.ac 06 2011 10 06 2011 25 2 71 75 Copyright © 2011 The Korean Society for Transplantation 2011 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Transplant glomerulopathy is a late complication of renal transplantation. The characteristic morphology of transplant glomerulopathy includes thickening of glomerular capillary loops with double contour, and duplication of glomerular basement membrane on electron microscopy. Clinical and experimental evidences support the role of antibody-mediated immune mechanism in the development of transplant glomerulopathy. Antibody-induced endothelial cell injury is the key pathogenesis of transplant glomerulopathy. The evolution of transplant glomerulopathy in the context of immunologic injury is briefly reviewed.

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Morphologic changes of transplant glomerulopathy. Glomerular capillary loops are thickened and show double contour (A). Electron microscopy reveals the widening of lamina rara interna and newly formed lamina densa (B). The peritubular capillary basement membrane is also multilayered (C). (A; Methenamine silver stain, ×400, B; Electron microscopy, ×3,000, C; Electron microscopy, ×10,000)

A proposed pathogenesis of transplant glomeruopathy.