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Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
Focal segmental glomerulosclerosis and renal transplantation.
1Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota 55415, USA. Gwen.Owen@co.hennepin.mn.us
Transplantation Proceedings
|April 21, 2007
Summary
Focal segmental glomerulosclerosis (FSGS) recurrence after kidney transplant is common. Plasmapheresis shows variable success but is often tried due to potential for complete recovery in some patients.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Background:
- Primary focal segmental glomerulosclerosis (FSGS) is a leading cause of nephrotic syndrome and end-stage renal disease.
- It involves damage to glomerular podocytes, with unclear etiology in primary cases.
- Secondary FSGS can result from conditions like obesity or heroin use, linked to a reduced podocyte-to-filtration surface area ratio.
Purpose of the Study:
- To review the challenges and treatment strategies for recurrent FSGS after renal transplantation.
- To explore the role of a potential circulating FSGS factor.
- To assess the efficacy of plasmapheresis and combination therapies.
Main Methods:
- Review of existing literature on FSGS recurrence post-transplantation.
- Analysis of identified risk factors and characteristics of recurrence.
- Evaluation of studies investigating plasmapheresis and adjunctive treatments.
Main Results:
- FSGS recurrence in renal allografts occurs in 20-30% of cases.
- Risk factors include rapid disease progression, early post-transplant proteinuria, and younger age.
- A circulating FSGS factor (30-50 kd protein) is implicated in recurrence.
Conclusions:
- Recurrent FSGS post-transplantation poses a significant clinical challenge.
- Plasmapheresis is a common therapeutic trial, with individually variable responses.
- Combination therapies with cyclophosphamide or mycophenolate mofetil have shown mixed results.
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