Membranous Glomerulonephritis in Two Human Renal Homotransplants

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Abstract
Two human kidney homotransplants are described in whom proteinuria more than 3.5 g/24 hr. was noted. One patient has all the stigmata of the nephrotic syndrome. Renal biopsy demonstrated the hlstologlc picture of chronic rejection and thickening of the glomerular capillary basement membranes. Electron microscopic study of the biopsy material from one patient showed thickened basement membranes and fusion of the podocytes. The glomerular lesions were reminiscent of late Ellis Type II (membranous) glomerulonephritis. Evidence is presented that these glomerular lesions are due to the immunological rejection processes and do not depend on the pre-existence of glomerulonephritis in the host prior to transplantation. It is suggested that the early cellular infiltration, the arterial obliteration and the glomerular capillary basement membrane thickening represent different phases of a homograft reaction which was modified, but not halted, by treatment.

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