Recurrent C3 glomerulopathy after kidney transplantation

Shota Obata, Pedro A.S. Vaz de Castro, Leonardo V. Riella, Paolo Cravedi

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

The complement system is part of innate immunity and is pivotal in protecting the body against pathogens and maintaining host homeostasis. Activation of the complement system is triggered through multiple pathways, including antibody deposition, a mannan-binding lectin, or activated complement deposition. C3 glomerulopathy (C3G) is a rare glomerular disease driven by complement dysregulation with high post-transplantation recurrence rates. Its treatment is mainly based on immunosuppressive therapies, specifically mycophenolate mofetil and glucocorticoids. Recent years have seen significant progress in understanding complement biology and its role in C3G pathophysiology. New complement-tergeting treatments have been developed and initial trials have shown promising results. However, challenges persist in C3G, with recurrent post-transplantation cases leading to suboptimal outcomes. This review discusses the pathophysiology and management of C3G, with a focus on its recurrence after kidney transplantation.

Original languageEnglish
Article number100839
JournalTransplantation Reviews
Volume38
Issue number2
DOIs
StatePublished - Apr 2024

Keywords

  • C3
  • C3 glomerulopathy
  • C3aR
  • C5
  • C5aR1
  • Complement-mediated glomerulonephritis
  • MAC
  • Recurrent glomerulonephritis
  • Renal transplantation
  • eculizumab

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