Tres casos de gammapatía monoclonal de significado renal postrasplante renal: nefropatía c3 de novo

Serra, Núria; Facundo, Carme; Canal, Cristina; Arce, Yolanda; Ayasreh, Nadia; Vilà, A; Bardají, Beatriz; Silva, Irene; López, Víctor A.; Benito, Silvia; Ballarín, José; Guirado, Lluís

doi:10.1016/j.nefro.2018.03.008

Cited by 2 publications

(1 citation statement)

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“…A total of 207 potentially relevant articles were identified and screened. Twenty-three articles were assessed in detail, of which 12 studies (7 cohort studies and 5 case series) [32,48,50,[71][72][73][74][75][76][77][78][79] consisting of 122 KTx patients with C3G (73 C3GN ( Table 1) and 49 DDD (Table 2)) were included in our systematic review ( Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Treatment of C3 Glomerulopathy in Adult Kidney Transplant Recipients: A Systematic Review

et al. 2020

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Background: C3 glomerulopathy (C3G), a rare glomerular disease mediated by alternative complement pathway dysregulation, is associated with a high rate of recurrence and graft loss after kidney transplantation (KTx). We aimed to assess the efficacy of different treatments for C3G recurrence after KTx. Methods: Databases (MEDLINE, EMBASE, and Cochrane Database) were searched from inception through 3 May, 2019. Studies were included that reported outcomes of adult KTx recipients with C3G. Effect estimates from individual studies were combined using the random-effects, generic inverse variance method of DerSimonian and Laird., The protocol for this meta-analysis is registered with PROSPERO (no. CRD42019125718). Results: Twelve studies (7 cohort studies and 5 case series) consisting of 122 KTx patients with C3G (73 C3 glomerulonephritis (C3GN) and 49 dense deposit disease (DDD)) were included. The pooled estimated rates of allograft loss among KTx patients with C3G were 33% (95% CI: 12–57%) after eculizumab, 42% (95% CI: 2–89%) after therapeutic plasma exchange (TPE), and 81% (95% CI: 50–100%) after rituximab. Subgroup analysis based on type of C3G was performed. Pooled estimated rates of allograft loss in C3GN KTx patients were 22% (95% CI: 5–46%) after eculizumab, 56% (95% CI: 6–100%) after TPE, and 70% (95% CI: 24–100%) after rituximab. Pooled estimated rates of allograft loss in DDD KTx patients were 53% (95% CI: 0–100%) after eculizumab. Data on allograft loss in DDD after TPE (1 case series, 0/2 (0%) allograft loss at 6 months) and rituximab (1 cohort, 3/3 (100%) allograft loss) were limited. Among 66 patients (38 C3GN, 28 DDD) who received no treatment (due to stable allograft function at presentation and/or clinical judgment of physicians), pooled estimated rates of allograft loss were 32% (95% CI: 7–64%) and 53% (95% CI: 28–77%) for C3GN and DDD, respectively. Among treated C3G patients, data on soluble membrane attack complex of complement (sMAC) were limited to patients treated with eculizumab (N = 7). 80% of patients with elevated sMAC before eculizumab responded to treatment. In addition, all patients who responded to eculizumab had normal sMAC levels after post-eculizumab. Conclusions: Our study suggests that the lowest incidence of allograft loss (33%) among KTX patients with C3G are those treated with eculizumab. Among those who received no treatment for C3G due to stable allograft function, there is a high incidence of allograft loss of 32% in C3GN and 53% in DDD. sMAC level may help to select good responders to eculizumab.

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Section: Resultsmentioning

confidence: 99%

Treatment of C3 Glomerulopathy in Adult Kidney Transplant Recipients: A Systematic Review

et al. 2020

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Updates on C3 Glomerulopathy in Kidney Transplantation: Pathogenesis and Treatment Options

Bartoli,

Dello Strologo,

Grandaliano

et al. 2024

IJMS

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C3 glomerulopathy is a rare disease, characterized by an abnormal activation of the complement’s alternative pathway that leads to the accumulation of the C3 component in the kidney. The disease recurs in more than half of kidney transplant recipients, with a significant impact on graft survival. Recurrence of the primary disease represents the second cause of graft loss after organ rejection. In C3 glomerulopathy, there are several risk factors which can promote a recurrence during transplantation, such as delayed graft function, infection and monoclonal gammopathy. All these events can trigger the alternative complement pathway. In this review, we summarize the impact of C3 glomerulopathy on kidney grafts and present the latest treatment options. The most widely used treatments for the disease include corticosteroids and mycophenolate mofetil, which are already used chronically by kidney transplant recipients; thus, additional treatments for C3 glomerulopathy are required. Currently, several studies using anti-complement drugs (i.e., eculizumab, Ravalizumab, avacopan) for C3 glomerulopathy in kidney transplant patients are ongoing with encouraging results.

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Tres casos de gammapatía monoclonal de significado renal postrasplante renal: nefropatía c3 de novo

Cited by 2 publications

References 10 publications

Treatment of C3 Glomerulopathy in Adult Kidney Transplant Recipients: A Systematic Review

Treatment of C3 Glomerulopathy in Adult Kidney Transplant Recipients: A Systematic Review

Updates on C3 Glomerulopathy in Kidney Transplantation: Pathogenesis and Treatment Options

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