1.Effects of pretransplant plasmapheresis and rituximab on recurrence of focal segmental glomerulosclerosis in adult renal transplant recipients.
Hoon Suk PARK ; Yuah HONG ; In O SUN ; Byung Ha CHUNG ; Hyung Wook KIM ; Bum Soon CHOI ; Cheol Whee PARK ; Dong Chan JIN ; Yong Soo KIM ; Chul Woo YANG
The Korean Journal of Internal Medicine 2014;29(4):482-488
BACKGROUND/AIMS: Recurrent focal segmental glomerulosclerosis (FSGS) following renal transplantation is relatively common. However, the risk factors and optimal pretransplant treatment preventing recurrence of FSGS remain controversial. METHODS: We retrospectively reviewed 27 adult renal transplant recipients with FSGS over a period of 10 years. We first compared possible risk factors for FSGS recurrence between the recurrence and nonrecurrence groups. Then we evaluated the effect of pretransplant plasmapheresis (PP; n = 4) and PP with rituximab (PP + RTX; n = 5) on recurrence of FSGS after transplantation compared to control patients that were not treated with these modalities. RESULTS: There were seven recurrences in 27 patients (25.9%), but there were no significant differences in possible risk factors for FSGS recurrence between the two groups. Recurrence rates between patients with pretransplant PP or PP + RTX and control patients were not significantly different (22.2% vs. 27.7%, p > 0.05). There was also no significant difference in recurrence between the pretransplant PP and PP + RTX groups (25% vs. 20%, p > 0.05). CONCLUSIONS: Pretransplant PP or PP + RTX do not significantly decrease the recurrence of FSGS in adult renal transplant candidates.
Adult
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Antibodies, Monoclonal, Murine-Derived/*administration & dosage
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Female
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Glomerulosclerosis, Focal Segmental/diagnosis/immunology/*surgery
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Humans
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Immunosuppressive Agents/*administration & dosage
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*Kidney Transplantation/adverse effects
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Male
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Middle Aged
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*Plasmapheresis
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Recurrence
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Retrospective Studies
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Risk Factors
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Treatment Outcome