There is currently insufficient information as to the pre-emptive use of rituximab for patients with idiopathic membranous GN and high pre-transplant levels of anti-PLA2R antibody, but this (or early initiation post-transplant) can be considered in those with detectable high levels of anti-PLA2R antibody with prior allograft failure from recurrent membranous GN or have persistent high or increasing levels of circulating anti-PLA2R antibody post-transplant with early histological recurrence. This evidence concerns the gene PLA2R1 and idiopathic membranous glomerulonephritis.