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Multiple-target therapy for posttransplant focal segmental glomerulosclerosis showed poor efficacy. High rates of infectious adverse events, including cytomegalovirus, led to treatment discontinuation and graft loss.

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Area of Science:

  • Nephrology
  • Transplantation Immunology

Background:

  • Posttransplant focal segmental glomerulosclerosis (FSGS) lacks a consensus treatment strategy.
  • Previous studies suggested favorable outcomes with multiple-target therapy (cyclosporine, prednisone, plasmapheresis).

Purpose of the Study:

  • To evaluate the efficacy and safety of multiple-target therapy in an independent cohort of patients with posttransplant FSGS.

Main Methods:

  • A single-center, prospective study involving thirteen patients with posttransplant FSGS.
  • Patients received high-dose intravenous cyclosporine, prednisone, and plasmapheresis.

Main Results:

  • Complete remission in 15.4%, partial remission in 15.4%.
  • 30.7% showed no remission; 38% experienced graft loss within 12 months.
  • 77% discontinued treatment due to infectious adverse events, primarily cytomegalovirus.

Conclusions:

  • Multiple-target therapy demonstrated poor efficacy in this cohort.
  • High incidence of infectious complications significantly limited treatment effectiveness and led to adverse outcomes.