Disease, does not recur in the kidney after renal transplant is –
**Core Concept**
Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys, leading to renal failure. In the context of renal transplantation, the recurrence of PKD in the transplanted kidney is a significant concern.
**Why the Correct Answer is Right**
The correct answer is **"D. Hyperoxaluria"**. Hyperoxaluria is a rare genetic disorder that leads to an excessive production of oxalate, which can cause kidney stones and damage to the kidneys. Unlike PKD, hyperoxaluria does not recur in the transplanted kidney because it is caused by a defect in the enzyme alanine-glyoxylate aminotransferase (AGT), which is not present in the transplanted kidney. The transplanted kidney will not produce excess oxalate, and therefore, hyperoxaluria will not recur.
**Why Each Wrong Option is Incorrect**
* **Option A:** PKD - PKD is a known cause of recurrence in the transplanted kidney due to the presence of cysts in the donor kidney.
* **Option B:** IgA nephropathy - IgA nephropathy can recur in the transplanted kidney, but it is not the correct answer in this context.
* **Option C:** Alport syndrome - Alport syndrome is a genetic disorder that affects the type IV collagen in the kidneys, but it does not recur in the transplanted kidney.
**Clinical Pearl / High-Yield Fact**
It is essential to note that the recurrence of certain diseases in the transplanted kidney can be influenced by the type of disease, the donor kidney, and the recipient's immune system.
**Correct Answer:** D. Hyperoxaluria.