Retransplantation of Multiple Organs: How Many Organs Should One Individual Receive?

2002 ◽  
Vol 12 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Lisa Griffin
Keyword(s):  
Focal Segmental Glomerulosclerosis ◽  
Heart Transplant ◽  
Pediatric Patients ◽  
Limited Resource ◽  
Ethical Decisions ◽  
Multiple Organs ◽  
Segmental Glomerulosclerosis ◽  
Donor Numbers ◽  
Artery Disease

Every year, the transplant waiting list gets longer, while donor numbers essentially remain the same. This makes the responsibility of being good stewards of this precious and limited resource greater than ever. Transplant teams, who are both committed to their patients and aware of this important responsibility, are left to make the difficult and ethical decisions regarding retransplantation. Retransplantation of organs in pediatric patients presents a different set of issues to consider, and the results are promising. This case study presents a boy who received a kidney transplant for focal segmental glomerulosclerosis at age 5. At age 11, because of the recurrence of focal segmental glomerulosclerosis and severe cardiomyopathy, he required a rare combined kidney-heart transplant. At age 17, he developed chronic renal failure and posttransplant coronary artery disease, most likely related to a period of noncompliance, and required yet another combined kidney-heart transplant. He is currently alive and well 2 years after transplantation.

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

Idiopathic collapsing focal segmental glomerulosclerosis in pediatric patients

2007 ◽  
Vol 22 (3) ◽  
pp. 396-402 ◽  
Author(s):  
Ahmed M. El-Refaey ◽  
Gaurav Kapur ◽  
Amrish Jain ◽  
Guillermo Hidalgo ◽  
Abubakr Imam ◽  
...  
Keyword(s):  
Focal Segmental Glomerulosclerosis ◽  
Pediatric Patients ◽  
Segmental Glomerulosclerosis

scholarly journals Genetic Study in Korean Pediatric Patients with Steroid-Resistant Nephrotic Syndrome or Focal Segmental Glomerulosclerosis

2020 ◽  
Vol 9 (6) ◽  
pp. 2013
Author(s):  
Eujin Park ◽  
Chung Lee ◽  
Nayoung K. D. Kim ◽  
Yo Han Ahn ◽  
Young Seo Park ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Focal Segmental Glomerulosclerosis ◽  
Detection Rate ◽  
Pediatric Patients ◽  
Mutation Detection ◽  
Genetic Diagnosis ◽  
Mutation Detection Rate ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Segmental Glomerulosclerosis

Steroid-resistant nephrotic syndrome (SRNS) is one of the major causes of end-stage renal disease (ESRD) in childhood and is mostly associated with focal segmental glomerulosclerosis (FSGS). More than 50 monogenic causes of SRNS or FSGS have been identified. Recently, the mutation detection rate in pediatric patients with SRNS has been reported to be approximately 30%. In this study, genotype-phenotype correlations in a cohort of 291 Korean pediatric patients with SRNS/FSGS were analyzed. The overall mutation detection rate was 43.6% (127 of 291 patients). WT1 was the most common causative gene (23.6%), followed by COQ6 (9.4%), NPHS1 (8.7%), NUP107 (7.1%), and COQ8B (6.3%). Mutations in COQ6, NUP107, and COQ8B were more frequently detected, and mutations in NPHS2 were less commonly detected in this cohort than in study cohorts from Western countries. The mutation detection rate was higher in patients with congenital onset, those who presented with proteinuria or chronic kidney disease/ESRD, and those who did not receive steroid treatment. Genetic diagnosis in patients with SRNS provides not only definitive diagnosis but also valuable information for decisions on treatment policy and prediction of prognosis. Therefore, further genotype-phenotype correlation studies are required.

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.

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