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Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
Plasmapheresis for recurrent posttransplant focal segmental glomerulosclerosis
C D Garcia1, V B Bittencourt, A Tumelero
1Santo Antônio Children's Hospital, Santa Casa Hospital Complex, School of Medical Sciences of Porto Alegre, Correa Lima 1493, Porto Alegre, 90850-250 Brazil. cdgarcia1@uol.com.br
Transplantation Proceedings
|August 16, 2006
Summary
Plasmapheresis effectively treats recurrent focal segmental glomerulosclerosis (FSGS) in pediatric kidney transplant recipients by removing a circulating permeability factor. Early treatment with plasmapheresis (PP) led to remission in most FSGS patients, preventing further recurrence.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Background:
- Focal segmental glomerulosclerosis (FSGS) recurrence post-kidney transplant is common, suggesting a circulating factor.
- This factor increases glomerular permeability to albumin, leading to proteinuria.
Purpose of the Study:
- To evaluate the therapeutic efficacy of plasmapheresis (PP) for treating recurrent FSGS in pediatric kidney transplant recipients.
- To assess the impact of PP on proteinuria and long-term outcomes.
Main Methods:
- Retrospective analysis of 24 kidney transplants in 21 pediatric FSGS patients.
- Nine patients received 10 cycles of PP initiated within 48 hours of recurrence.
- Standard immunosuppression with high-dose cyclosporine, mycophenolate, and prednisone was used.
Main Results:
- 55.5% of PP-treated patients achieved complete remission; 12% achieved partial remission.
- No remission was observed in the five non-PP treated patients.
- Remission after PP was associated with no recurrence during 2.6 years follow-up.
Conclusions:
- Plasmapheresis is an effective treatment for recurrent FSGS in pediatric kidney transplant recipients.
- Prompt initiation of PP after recurrence is crucial for achieving remission and preventing graft loss.
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