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Related Experiment Videos

Recurrent disease in renal transplants.

Chas G Newstead1

  • 1Department of Renal Medicine, St James's University Hospital, Leeds, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|September 4, 2003
PubMed
Summary

Recurrence of focal segmental glomerulosclerosis (FSGS) after kidney transplant is common, especially in children. Early aggressive disease and prior graft recurrence predict transplant loss, while familial FSGS has a good prognosis.

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Glomerular Diseases

Background:

  • Minimal change glomerulonephritis and FSGS can occur post-renal transplantation.
  • FSGS recurrence affects approximately 20% of kidney transplant recipients.
  • Predictive factors for FSGS recurrence include young age, aggressive disease course, and diffuse mesangial proliferation.

Purpose of the Study:

  • To review the occurrence, prediction, and management of FSGS recurrence post-kidney transplantation.
  • To differentiate between idiopathic and familial FSGS in the context of transplantation.
  • To assess the impact of FSGS recurrence on graft survival and compare outcomes with other glomerular disorders.

Main Methods:

  • Literature review of studies on FSGS recurrence after renal transplantation.

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  • Analysis of factors influencing graft survival in pediatric and adult transplant recipients.
  • Evaluation of treatment strategies for recurrent FSGS.
  • Main Results:

    • Pediatric FSGS patients have significantly higher graft loss rates compared to those with structural disorders.
    • Recurrence in a subsequent graft is likely if the initial graft was affected.
    • Plasma exchange and cyclophosphamide are effective treatments for recurrent FSGS.

    Conclusions:

    • FSGS recurrence poses a significant risk to graft survival, particularly in pediatric recipients.
    • Familial FSGS is distinct from idiopathic FSGS and associated with better transplant outcomes.
    • Adults with secondary FSGS have a low risk of recurrence post-transplant.