scholarly journals Treatment of Recurrent Focal Segmental Glomerulosclerosis in Pediatric Kidney Transplant Recipients: Effect of Rituximab

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Christine Sethna ◽  
Corinne Benchimol ◽  
Hilary Hotchkiss ◽  
Rachel Frank ◽  
Lulette Infante ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Renal Transplantation ◽  
Side Effects ◽  
Focal Segmental Glomerulosclerosis ◽  
Pediatric Patients ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adverse Side Effects ◽  
Segmental Glomerulosclerosis

Recurrence of focal segmental glomerulosclerosis (FSGS) after renal transplantation is a complication that often leads to graft loss. There is no consensus on the optimal treatment of recurrent FSGS. Rituximab, a monoclonal antibody to CD20, may be a useful treatment of this complication.Methods. We report four pediatric cases of recurrent FSGS treated with rituximab and plasmapheresis.Results. Four children (2M/2F), age 15.3 ± 2.6, with recurrent FSGS posttransplant were identified. Four doses of rituximab were administered 171 ± 180 days posttransplant and 114 ± 169 days after the start of plasmapheresis. Three children responded with complete remission, one of whom relapsed after four months. One child had a partial response with a decrease in proteinuria that was not sustained. No adverse side effects were reported during treatment or followup (mean 22.5 months).Conclusions. Rituximab is a safe and well-tolerated ancillary treatment for recurrent FSGS in pediatric patients in conjunction with plasmapheresis.

scholarly journals Pediatric Focal Segmental Glomerulosclerosis: Favorable Transplantation Outcome With Plasma Exchange

2021 ◽  
Author(s):  
Fatina I Fadel ◽  
Hafez M Bazaraa ◽  
Mohamed A Abdel Mawla ◽  
Doaa M Salah
Keyword(s):  
Plasma Exchange ◽  
Focal Segmental Glomerulosclerosis ◽  
Survival Data ◽  
Early Recurrence ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Segmental Glomerulosclerosis ◽  
Kaplan Meier ◽  
One Year

Abstract Background: Although kidney transplantation (KT) is the treatment of choice for pediatric kidney failure (KF); concerns for recurrence in cases of focal segmental glomerulosclerosis (FSGS) are still present. This study aimed to investigate the outcome of KT in children with KF secondary to FSGS, with implementation of preemptive perioperative plasma exchange (PE) for non-genetically proven patients.Methods: Forty FSGS pediatric kidney transplant recipients were studied. Of them: 12 patients (30%) had genetically proven NPHS2 mutations/familial and 28 (70%) were sporadic FSGS patients. Sporadic patients electively received 6 preoperative PE sessions. Recurrence of proteinuria was managed with PE and Rituximab (RTX). Kaplan-Meier curves were used to analyze graft and recurrence free survival data.Results: The mean follow-up duration after KT was 3.8 ± 2.86 years. Recurrence of proteinuria was encountered early postoperative in 11 patients (27.5%) and late (1.6 and 2.9 years after KT) in 2 patients (5%). Proteinuria was less in patients underwent native nephrectomy than others immediately postoperative and at assessment (p= 0.002 & 0.0031 respectively). One-year graft and patient survival was 93.8% with a mean 1-year serum creatinine of 0.67 ± 0.25 mg/dl. Three graft losses (7.5%) were due to chronic rejection 3.3, 3.75 and 4.17 years after KT and 2 patients' mortality (5%) occurred early postoperative (first 2 weeks) due to infection.Conclusion: FSGS transplanted children have favorable outcomes with perioperative PE for non-genetically proven cases. Early recurrence after KT can be successfully managed with PE and RTX.

Recurrent focal segmental glomerulosclerosis following renal transplantation in Korean pediatric patients

2001 ◽  
Vol 5 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Sang Joon Kim ◽  
Jongwon Ha ◽  
In Mok Jung ◽  
Moon Sang Ahn ◽  
Minyoung Kim ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Focal Segmental Glomerulosclerosis ◽  
Pediatric Patients ◽  
Segmental Glomerulosclerosis

scholarly journals Response to Steroid and Immunosuppressive Therapies May Predict Post-transplant Recurrence of Focal Segmental Glomerulosclerosis

2021 ◽  
Author(s):  
Kenichiro Miura ◽  
Taro Ando ◽  
Shoichiro Kanda ◽  
Taeko Hashimoto ◽  
Naoto Kaneko ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Genetic Testing ◽  
Focal Segmental Glomerulosclerosis ◽  
Immunosuppressive Agents ◽  
Recurrence Risk ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Segmental Glomerulosclerosis ◽  
Steroid Sensitivity

Abstract Recurrence of focal segmental glomerulosclerosis (FSGS) is a major challenge in kidney transplantation. Several clinical factors, including initial steroid sensitivity, have been associated with increased post-transplant FSGS recurrence risk. However, conflicting data have been reported, possibly due to the heterogeneous pathophysiology of FSGS and the lack of genetic testing of FSGS patients. Further, the response to immunosuppressive therapies have not been evaluated. This study aimed to assess the risk factors for post-transplant recurrence in stringently selected patients based on a comprehensive clinicopathological evaluation and genetic testing. Fifty-nine patients aged 1–25 years at FSGS onset who underwent kidney transplantation between 2002 and 2018 were enrolled. Patients with secondary, familial, syndromic, and genetic FSGS and those who did not undergo genetic testing were excluded. Data from 15 kidney transplant recipients were analyzed. Nine (60%) patients experienced post-transplant FSGS recurrence, while six patients did not. The proportion of patients who achieved complete or partial remission with initial steroid and/or additional therapies with immunosuppressive agents and/or plasmapheresis was significantly higher in the FSGS recurrence group than the group without FSGS recurrence (P=0.04). In conclusion, this study suggests that the response to steroid treatment, other immunosuppressive agents, and/or plasmapheresis may predict post-transplant FSGS recurrence.

scholarly journals Transplant renal artery stenosis without hypertension: A case report

2019 ◽  
Vol 9 (1) ◽  
pp. e11-e11
Author(s):  
Fereshteh Saddadi ◽  
Seyyed Mehdi Hoseini ◽  
Faezeh Rasolian ◽  
Mohammad Hassan Fallahkohan
Keyword(s):  
Case Report ◽  
Renal Transplantation ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Graft Loss ◽  
Artery Stenosis ◽  
Diagnostic Tools ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients

In kidney transplant recipients, the renal artery stenosis is cause of graft dysfunction and graft loss. Here we describe a case that leads to graft loss. The nephrologist should know about its etiologies, symptoms and diagnostic tools and also its treatment after renal transplantation.

Clinical features and outcomes of kidney transplant recipients with focal segmental glomerulosclerosis recurrence

Nephrology ◽  
2019 ◽  
Vol 24 (11) ◽  
pp. 1179-1188 ◽  
Author(s):  
Juliana B Mansur ◽  
Tainá V Sandes‐Freitas ◽  
Gianna M Kirsztajn ◽  
Marina P Cristelli ◽  
Gustavo F Mata ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Focal Segmental Glomerulosclerosis ◽  
Clinical Features ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Segmental Glomerulosclerosis
Sign in / Sign up

Export Citation Format

Share Document