Kidney Transplantation in Patients with Focal Segmental Glomerulosclerosis.
- Author:
Hyun Jin LEE
1
;
Hyoung Tae KIM
;
Won Hyun CHO
;
Jung Hoon SUNG
;
Kyu Bok JIN
;
Eun Ah HWANG
;
Seung Yup HAN
;
Sung Bae PARK
;
Hyun Chul KIM
;
Shin Heon JU
;
Ja Hyun KOO
Author Information
1. Department of Surgery, Dongsan Hospital, School of Medicine, Keimyung University, Daegu, Korea. htkim@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Focal segmental glomerulosclerosis;
Kidney transplantation;
Plasmapheresis
- MeSH:
Biopsy;
Cyclosporine;
Glomerulosclerosis, Focal Segmental*;
Graft Survival;
Humans;
Kidney Transplantation*;
Kidney*;
Plasmapheresis;
Proteinuria;
Recurrence;
Retrospective Studies;
Risk Factors;
Statistics as Topic;
Tacrolimus;
Transplants
- From:The Journal of the Korean Society for Transplantation
2006;20(2):201-206
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose: Kidney transplantation (KT) is one of the important treatment modality for the patients with focal segmental glomerulosclerosis (FSGS), but high recurrence rate and resulting graft failure is still a great obstacle. In order to compare the results of transplantation for recipient with FSGS, we reviewed our cases retrospectively. Methods: Thirty-six biopsy proven FSGS were reviewed and compared their clinical characteristics according to their recurrence status, retrospectively. Patient with significant proteinuria after KT was re-biopsied and light- and electron-microscopic study were done to confirm the recurrence of original disease. Results: Recurrence of FSGS was confirmed histologically in 13 (36%) recipients. Among 15 failed grafts, 9 grafts lost their function by recurrence of FSGS. Higher rate of acute rejection associated in recurred group (53% vs 39%). Five-year graft survival of recurred group was significantly lower than non-recurred group (65% vs 78%, P=0.0071). Cyclosporin group showed more frequent recurrence of FSGS after transplantation than tacrolimus group but no statistical significance (P>0.05). Plasmapheresis (PP) was done in 8 patients with early recurred FSGS and was effective in reducing the grade of proteinuria. Their long-term graft survival, however, was poor even though half of the recurred patients maintain their graft function until 5 years after PP. Conclusion: Our data showed that the recurred FSGS group showed higher rate of graft loss and poor graft survival. Since the FSGS recurrence is directly related with graft survival, large data analysis will be necessary to analyze the risk factor of recurrence and prevent adverse effect of recurrence of FSGS after KT.
