Recurrence of focal segmental glomerulosclerosis in renal allograft: an in-depth review.
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.
Vinai
Modini
M
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Waber
Pamela
P
Seikaly
Mouin G
MG
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D065095:Calcineurin Inhibitors; D002648:Child; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D006084:Graft Rejection; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D012008:Recurrence; D012307:Risk Factors; D000069283:Rituximab; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D065095:Calcineurin Inhibitors; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab