Chronic transplant glomerulopathy: New insights into pathogenesis.

There have been recent significant advances in short-term outcomes in renal transplantation, however, long-term allograft survival remains a challenge. With reported incidences as high of 74.5% of chronic graft loss in patients with biopsies showing transplant glomerulopathy (TG), this syndrome represents an important factor for chronic allograft complications. In this review we show an overview of the novel mechanistic insights into pathogenesis of TG, as well as a brief description of the pathology, diagnosis and newer prognostic indices within TG diagnosis. These data raise intriguing roles for cell-mediated immunity and podocyte stress in TG as well as reinforce previous associations of TG with ABMR. We also delve into management strategies for TG and report the paucity of existing clinical trial data for this prevalent condition in renal transplants.

肾移植的短期预后近期有了重大进展，然而，移植物的长期存活仍然是一个挑战。据报道，在活检显示移植肾小球病（TG）的患者中，慢性移植物丢失的发生率高达74.5%，这种综合征是慢性移植物并发症的一个重要因素。在这篇综述中，我们概述了对TG发病机制的新的机制性见解，并简要描述了TG诊断中的病理学、诊断方法和新的预后指标。这些数据揭示了细胞介导的免疫和足细胞应激在TG中的有趣作用，并强化了之前TG与抗体介导的排斥反应（ABMR）的关联。我们还深入探讨了TG的管理策略，并指出针对肾移植中这种常见病症的现有临床试验数据匮乏。