Treatment of Post-Transplant Recurrent FSGS in Children Using Plasmapheresis and Augmentation of Immunosuppression

Abstract Background: Up to 60% of pediatric renal transplant recipients with end-stage renal disease due to primary focal and segmental glomerulosclerosis (FSGS) may develop recurrent disease. Such recurrence is associated with poor prognosis if no remission is achieved. We report a single center experience with a protocol based on plasmaphereis and increased immunosuppression that resulted in a high long-lived remission rates.Methods: This retrospective cohort study included consecutive pediatric renal transplant patients with recurrent FSGS treated with a standardized protocol using plasmapheresis and cyclophosphamide to supplement usual post-transplant immunosuppression with calcineurin inhibitors and steroids. Relapse was defined as urinary protein/creatinine ratio >1.0g/g and remission as <0.5g/g. Results: 15 patients with FSGS recurrence post-transplant were treated. All had therapy-resistant FSGS in native kidneys and had been on dialysis from 4-10 years. Of the 15, one died perioperatively from a pulmonary thromboembolism. 13 others achieved a complete remission within 3 months of treatment for FSGS recurrence. After a median follow-up period of 4 years, there were no recurrences of significant proteinuria. Conclusion: The addition of plasmapheresis and cyclophosphamide to a calcineurin- and steroid-based immunosuppression regime was highy successful in inducing high remission rates with recurrent FSGS. Prospective trials are needed to evaluate further the efficacy of increased immunosuppression along with plasmapheresis in this setting.

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1248 RENAL CELL CARCINOMA IN PATIENTS WITH END-STAGE RENAL DISEASE AND RENAL TRANSPLANT RECIPIENTS: A SINGLE CENTER EXPERIENCE

The Journal of Urology ◽

10.1016/j.juro.2010.02.792 ◽

2010 ◽

Vol 183 (4S) ◽

Author(s):

Younes Bayoud ◽

Johann Menard ◽

Frederic Staerman

Keyword(s):

Renal Cell Carcinoma ◽

Renal Transplant ◽

Renal Disease ◽

End Stage Renal Disease ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Single Center ◽

Single Center Experience ◽

Stage Renal Disease ◽

End Stage

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Malignant disease in renal transplant recipients: Our experience

Acta chirurgica iugoslavica ◽

10.2298/aci1201049b ◽

2012 ◽

Vol 59 (1) ◽

pp. 49-51

Author(s):

Radmila Blagojevic-Lazic ◽

Dragana Radivojevic ◽

Vladan Andrejevic ◽

Zoran Dzamic ◽

Miodrag Acimovic ◽

...

Keyword(s):

Renal Transplant ◽

Transitional Cell ◽

High Risk Group ◽

Renal Transplant Recipients ◽

Transplant Patients ◽

Living Donor Transplantation ◽

Carcinoma Of The Bladder ◽

Cellular And Humoral Immunity ◽

Stage Renal Disease ◽

End Stage

Kidney transplantation is a treatment of choice for patient with end stage renal disease. Chronic renal failure is characterized with weak cellular and humoral immunity. In our paper we present our experience with presence of malignancy in renal transplant patients. Urology clinic in Belgrade transplanted 411 patients over the period of 16 years. Living donor transplantation was performed for 272 and cadaveric kidney transplant for 139 patients. In the postoperative follow up, malignancies were diagnosed in 7 of the transplanted patients. Three patients developed basal cell skin carcinoma, one was diagnosed with adenocarcinoma of the transplanted kidney, one developed transitional cell carcinoma of the bladder and testicular tumors were diagnosed in two patients. Postoperative immunosuppressive therapy usually double or triple when patients are in the immunological high risk group. Incidence of malignancy according to big health centers is around 1 in every 1000 transplanted patients. It is also noted the rise of incidence of malignancies in transplanted patient in over 50%.

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Ocular disorders in renal transplant patients in Ethiopia.

10.21203/rs.2.485/v1 ◽

2019 ◽

Author(s):

Lemlem Tamrat Tigabu ◽

Ewenat Gebrehanna

Keyword(s):

Renal Transplant ◽

Renal Disease ◽

Dry Eye ◽

End Stage Renal Disease ◽

Renal Transplant Recipients ◽

Ocular Complication ◽

Transplant Patients ◽

Renal Transplant Patients ◽

Stage Renal Disease ◽

End Stage

Abstract Abstract Background : Renal transplantation has become a very successful and routine procedure of all organ transplant procedures. Visual loss is a rare but potentially devastating ocular complication of organ transplantation. Postoperative therapy with immunosuppressant, steroids and the cause of the end stage renal disease were said to be associated with the development of eye disorders like cataract, high intraocular pressure ,ocular surface disorders, opportunistic infections and neurotoxic conditions. Nowadays, Post transplant patients have better survival rates and enjoy improved quality of life so one should look for complications on time and solve them accordingly. The objective of this study is to determine ocular problems in renal transplant recipients in Ethiopian patients. Methods: It is a across sectional study done at Saint Paul's Hospital Millennium Medical College(SPHMMC) from October 2017 to December 2018. All post renal transplant patients who were having follow up at renal transplant unit were taken for the study. Descriptive analysis was done to determine means, frequencies and proportions of the various variables. Result : There were a total of 135 renal transplant subjects including 95(70.4%) male and 40(29.6 %) female . The mean age of all the study subjects were 34.4+ 12.1(Range 10 - 69) years. The cause of renal diseases is not known in majority of the study subjects 112(83%).More than 95% of all the study subjects were on multiple immunosuppressant therapy. Of all the individuals examined 128(94.8%) of them have one or more eye problems. The most prevalent ocular abnormality detected were dry eye 76(59.4%), optic neuropathies 10 (7.9%),Cataract 8(6.2%) and retinal pigment abnormality 9(7%). There were no significant sight threatening complications observed in relation to the immunosuppressive therapy or the diseases itself. Conclusions : Dry eye is the most commonest eye problem identified among renal transplant patients which is not related to the prolonged use of immunosuppressives or the end stage renal disease. Key words: Renal transplant, immunosuppressive, ocular complication, end stage renal disease.

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