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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The membranous pattern in kidney allograft biopsies is an uncommon finding with uncertain prognostic significance. It may result from both autoimmune mechanisms, such as recurrent or de novo glomerular disease, and alloimmune injury driven by antibody-mediated rejection (AMR). Assessing the clinical impact of this pattern is essential to determine its value as a prognostic marker and to guide management strategies in kidney transplantation. This study aims to provide evidence on the prognostic relevance of the membranous pattern as a risk marker in clinical transplant practice.
This was a single-center, retrospective cohort study including renal allograft biopsies performed between 2010 and 2020. Cases showing a membranous pattern on light microscopy or immune complex deposits on direct immunofluorescence were identified and categorized into three groups: Group 1, membranous pattern associated with antibody-mediated rejection (MP-AMR); Group 2, membranous pattern associated with lupus nephritis or recurrence of primary glomerulopathy (MP-recurrence); A third control group (Group 3) consisting of patients with AMR without a membranous pattern (non-MP AMR) was included and matched for comparative analysis. Graft survival was evaluated using Kaplan–Meier curves and Cox proportional hazards models.
A total of 3,221 histopathological reports were reviewed, of which 56 patients showed a membranous pattern. The median time from transplantation to biopsy was 82 (37-150) months. There was a higher proportion of female patients. The average age at kidney transplant was 39 years. The primary cause of chronic kidney disease was undetermined (46%), followed by lupus nephritis (28%). Most patients received a living-related donor graft (68%).
The membranous pattern was associated with AMR in 32 cases (57%), Lupus nephritis in 14 cases (25%), and recurrent or de-novo membranous nephropathy in 10 cases (18%). Significant proteinuria was present in 42% of cases, and this was associated with a lower treatment response and lower survival with a cut off value of 0.5 g/g. [Figure1C]. Overall graft survival at 5 years was 60.8% [Figure1A], which was significantly lower in the context of AMR (Group 1) versus glomerular recurrence (Group 2) (50% vs. 82%; p<0.01) [Figure1B] or versus AMR without a membranous pattern (Group 3) (54% vs 85%; p=0.01) [Figure1D]. In the Cox regression analysis, cases with AMR, chronic glomerulopathy (cg>1b), and proteinuria were associated with poor graft survival.
The membranous pattern associated with AMR is linked to significantly poorer graft survival compared with patients exhibiting de novo or recurrent membranous nephropathy, as well as those with AMR lacking a membranous pattern. These findings underscore the value of the membranous pattern as a marker of both clinical and histological risk in kidney transplantation.
