Recurrent Renal Disease After Transplantation

In the pediatric population, primary glomerulonephritis diseases, including focal segmental glomerulosclerosis (FSGS), IgA nephropathy (IgAN), and membranoproliferative GN (MPGN), are the second most common cause of end-stage renal disease (ESRD), representing 21.1% of all pediatric ESRD patients [1]. In addition, secondary glomerular diseases, including systemic lupus erythematosus (SLE), ANCA-associated vasculitis (AAV), and complement-mediated glomerular disease, are the fourth leading cause of ESRD, representing 8.0% of pediatric patients with ESRD [1]. These conditions can recur after transplantation with varying effects on the allograft and long-term transplant outcomes (Table 1). The goal of this chapter is to describe the epidemiology, pathophysiology, treatment options, and allograft outcomes for patients in whom these conditions recur after transplant.