Structural and Histopathologic Changes in Renal Allografts from an Infant Donor

Abstract

Prognosis of a renal allograft is dependent on many factors, including but not limited to recipient's age, sex, and size. One underreported finding in an adult patient receiving a pediatric allograft is splitting and lamellation of the glomerular basement membrane, similar to that seen in Alport's syndrome. Histological and ultrastructural changes must be monitored after transplant, and changes can be detected using light microscopy and electron microscopy. These changes are believed to be due to hyperperfusion and high filtration pressures in an immature pediatric kidney. Despite these anomalies, pediatric allografts are comparable to adult allografts in regard to intermediate and long-term prognosis. In this report, we describe the case of a 20-year-old man who received an en-bloc kidney transplant from a 9-month-old female, with resultant hematuria, subnephrotic range proteinuria and glomerular basement membrane changes.