title: Flowcytometric analysis of lymphocytapheresis in a patient with recurrent FSGS after renal transplant.
abstract: Frequently, focal segmental glomerulosclerosis (FSGS) recurs after renal transplantation, resulting in poor graft survival. Pathological mechanisms of the recurrence are still unknown, but both B and T cell disorders are suspected based on much evidence. This supports theoretical benefits using plasma exchange (PE) and lymphocytapheresis (LCAP). A renal transplant was performed for a 35-year-old woman, who suffered steroid-resistant FSGS and developed to chronic kidney disease stage 5D at 31 years old. We treated the patient with recurrent FSGS by LACP and examined whether peripheral neutrophils were dynamically changed after the therapy. Further, we performed flowcytometric analysis to examine lymphocyte fractions before and after LCAP. The decrease of helper (CD4 positive) and memory (CD4 and CD45RO positive) T cells was prominent after LCAP. Although B cells were at the nadir because of rituximab treatment, LCAP also decreased peripheral B cells. These suggest that LCAP has the potential to suppress the activities of recurrent FSGS after renal transplant.
authors.affiliation: The 4th Department of Medicine, Tokyo Women's Medical University, Japan. kaokano@kc.twmu.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Okano
authors.forename: Himiko
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Hikohiro
authors.initials: H
authors.lastname: Jinnai
authors.forename: Tomihito
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Mari
authors.initials: M
authors.lastname: Takano
authors.forename: Misao
authors.initials: M
authors.lastname: Tsukada
authors.forename: Naoko
authors.initials: N
authors.lastname: Miwa
authors.forename: Naoki
authors.initials: N
authors.lastname: Kimata
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiba
mesh_terms: D000328:Adult; D005260:Female; D005434:Flow Cytometry; D005923:Glomerulosclerosis, Focal Segmental / Q000276:immunology / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D007937:Leukapheresis; D016131:Lymphocyte Subsets / Q000276:immunology; D010951:Plasma Exchange; D012008:Recurrence