title: Long-Term Outcome of Kidney Transplantation in Recipients with Focal Segmental Glomerulosclerosis.
abstract: FSGS can recur after kidney transplantation and is associated with poor graft outcomes. We aimed to assess the incidence of FSGS recurrence post-transplant and determine the effect of graft source on recurrence and graft survival in patients with biopsy-proven FSGS.
  
  
  
  Using the Australian and New Zealand Dialysis and Transplant Registry, we assessed incidence of FSGS, the influence of donor type on the risk of FSGS recurrence, and graft loss in recipients with ESRD caused by primary FSGS using Kaplan-Meier and logistic regression analyses.
  
  
  
  Between 1992 and 2011, 736 first kidney transplants were performed in 666 adults and 70 children (≤20 years old) with biopsy-proven primary FSGS. FSGS recurred in 76 (10.3%) patients. Younger age (P<0.001), nonwhite ethnicity (P=0.02), and having a live donor (P=0.02) were independent risk factors associated with recurrence. Median graft survival was significantly better for live donor compared with deceased donor grafts (14.8 versus 12.1 years; P<0.01). Disease recurrence predicted poor graft outcomes, with 52% (95% confidence interval, 40% to 63%) 5-year graft survival in the recurrence group compared with 83% (95% confidence interval, 79% to 86%) in the group without recurrent disease (P<0.001).
  
  
  
  FSGS recurrence after kidney transplantation was more common in live donor kidneys. Despite this, graft survival in live donor recipients was significantly better for both children and adults with FSGS. We propose that live donor transplantation should not be avoided in patients with FSGS.
authors: Child and Adolescent Renal Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia; and.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors: Anna
authors: A
authors: Francis
authors: Child and Adolescent Renal Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia; and.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors: Peter
authors: P
authors: Trnka
authors: Child and Adolescent Renal Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia; and.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors: Steven J
authors: SJ
authors: McTaggart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001315:Australia; D002648:Child; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications* / Q000208:ethnology; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012008:Recurrence; D012042:Registries; D013997:Time Factors; D055815:Young Adult
keywords: Adult; Australia; Biopsy; Child; Glomerulosclerosis, Focal; Graft Survival; Humans; Incidence; Kidney Failure, Chronic; Living Donors; Logistic Models; New Zealand; Registries; deceased donor; focal segmental glomerulosclerosis; graft survival; kidney; kidney transplantation; living donor; renal dialysis; risk factors