Renal transplantation in Alport's syndrome: anti-glomerular basement membrane glomerulonephritis in the allograft

Eleven patients with Alport's syndrome had renal transplantation between 1963 and 1980. The mean follow-up is 6 years (6 months to 14 years). All 11 patients are currently alive. Ten have functioning grafts, and in nine the serum creatinine concentration is less than 2 mg/dl. Three patients received a second allograft. Histologic study of the allografts that were lost revealed a diffuse crescentic glomerulonephritis with strongly positive linear IgG staining of the glomerular basement membrane in the allografts of two of the three patients; circulating antiglomerular basement membrane antibodies were present in one patient. These two patients had successful retransplantation and they remain well 1 1/2 and 4 1/2 years later. Renal transplantation in patients with Alport's syndrome is a worthwhile and very satisfactory procedure.