Recurrence of de novo graft membranous glomerulonephritis.

Graft membranous nephropathy (MN) appears mainly de novo or, less frequently, develops in patients whose original disease was MN. The rarity of the latter occurrence contrasts with the frequency of MN as the original disease: the existence of renal recurrence may thus be questioned. We report a patient with terminal renal failure due to focal glomerulosclerosis; typical MN developed de novo in the first and recurred in the third graft. This observation establishes that recurrence of MN is a real phenomenon and demonstrates that the factor(s) determining recurrence may appear only after transplantation. Neither HBs nor antilymphocyte serum antigens were found along the basement membrane. The late onset of proteinuria after the third demonstrates that the delayed appearance of clinical signs of glomerular disease does not rule out the occurrence of MN.