Transplant glomerulopathy: it's not always about chronic rejection.

Transplant glomerulopathy (TG) is a morphologic lesion of renal allografts characterized by duplication of the glomerular basement membrane and is widely accepted as a manifestation of chronic antibody-mediated rejection (AMR). However, TG is not specific for chronic AMR, and this pattern of injury may result from a number of disease processes affecting the glomerular endothelium. Baid-Agrawal and co-workers consider three different, but not mutually exclusive, processes that can produce morphologic lesions of TG: chronic AMR, hepatitis C, and thrombotic microangiopathy.