Recurrence of focal segmental glomerulosclerosis in renal allograft: An in-depth review

Authors


Mouin G. Seikaly, MD, Professor of Pediatrics, UT Southwestern Medical Center at Dallas and Director, Pediatric Kidney Transplant, Children’s Medical Center of Dallas, 1935 Motor Street, Dallas, TX 75235, USA
Tel.: 214 456 6005
Fax: 214 456 6456
E-mail: mouin.seikaly@UTSouthwestern.edu

Abstract

Vinai M, Waber P, Seikaly MG. Recurrence of focal segmental glomerulosclerosis in renal allograft: An in-depth review.
Pediatr Transplantation 2010: 14: 314–325. © 2010 John Wiley & Sons A/S.

Abstract:  Focal segmental glomerulosclerosis is a major cause of chronic kidney disease requiring transplantation in children. Recurrence rate in the renal allograft transplantation is as high as 50%. Recurrence of FSGS is associated with renal dysfunction and early graft loss. To date, there is no established therapy for recurrent FSGS after renal transplant. We have reviewed the current English literature in order to summarize current practices with emphasis on graft outcome. We conclude that despite multiple approaches to the post transplant management of recurrent FSGS, none have been shown to be consistently beneficial. Currently, pheresis combined with high dose anti-calcineurin with or without rituximab seems to be the most promising. Further controlled studies are needed to define the optimal therapeutic regimens to treat recurrent of FSGS.

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