scholarly journals Plasma Exchange for the Recurrence of Primary Focal Segmental Glomerulosclerosis in Adult Renal Transplant Recipients: A Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Georgios Vlachopanos ◽  
Argyrios Georgalis ◽  
Harikleia Gakiopoulou
Keyword(s):  
Plasma Exchange ◽  
Focal Segmental Glomerulosclerosis ◽  
Renal Allograft ◽  
Meta Analysis ◽  
Composite Endpoint ◽  
Renal Transplant Recipients ◽  
Allograft Survival ◽  
Segmental Glomerulosclerosis ◽  
Statistical Heterogeneity ◽  
Allograft Loss

Background. Posttransplant recurrence of primary focal segmental glomerulosclerosis (rFSGS) in the form of massive proteinuria is not uncommon and has detrimental consequences on renal allograft survival. A putative circulating permeability factor has been implicated in the pathogenesis leading to widespread use of plasma exchange (PLEX). We reviewed published studies to assess the role of PLEX on treatment of rFSGS in adults.Methods. Eligible manuscripts compared PLEX or variants with conventional care for inducing proteinuria remission (PR) in rFSGS and were identified through MEDLINE and reference lists. Data were abstracted in parallel by two reviewers.Results. We detected 6 nonrandomized studies with 117 cases enrolled. In a random effects model, the pooled risk ratio for the composite endpoint of partial or complete PR was 0,38 in favour of PLEX (95% CI: 0,23–0,61). No statistical heterogeneity was observed among included studies (I2=0%,p= 0,42). On average, 9–26 PLEX sessions were performed to achieve PR. Renal allograft loss due to recurrence was lower (range: 0%–67%) in patients treated with PLEX.Conclusion. Notwithstanding the inherent limitations of small, observational trials, PLEX appears to be effective for PR in rFSGS. Additional research is needed to further elucidate its optimal use and impact on long-term allograft survival.

scholarly journals Renal allograft survival in transplant recipients with focal segmental glomerulosclerosis

2019 ◽  
Vol 9 (2) ◽  
pp. e15-e15
Author(s):  
Takahiro Shinzato ◽  
Yoshitaka kinoshita ◽  
Taro Kubo ◽  
Toshihiro Shimizu ◽  
Koji Nanmoku ◽  
...  
Keyword(s):  
Focal Segmental Glomerulosclerosis ◽  
Medical Records ◽  
Renal Allograft ◽  
De Novo ◽  
Transplant Recipients ◽  
Allograft Survival ◽  
Renal Allografts ◽  
Not Otherwise Specified ◽  
Segmental Glomerulosclerosis ◽  
Cadaveric Donors

Introduction: The frequency that idiopathic focal segmental glomerulosclerosis (FSGS) recurs in renal allografts is reportedly 20-50%, but the epidemiology of secondary FSGS in this setting has scarcely been addressed. Objectives: The aim of this study was to examine the incidence, etiology, and subtypes of FSGS in renal allograft recipients and allograft survival in recipients with FSGS. Patients and Methods: As a retrospective review, we examined medical records of 359 consecutive renal allograft recipients (living donors, 329; cadaveric donors, 30). In 121 of these patients, allograft dysfunction or proteinuria prompted biopsies. We compared allograft survival in recipients with and without FSGS. We then determined histologic subtypes of FSGS using the Columbia classification and categorized FSGS as recurrent or de novo, and idiopathic or secondary. Results: Of 121 subjects who were biopsied, six with inadequate specimens (<10 glomeruli) were excluded. Only 17 of those remaining (n=115) were diagnosed as secondary FSGS. Renal allograft survival did not differ significantly in patients with or without FSGS (P=0.953). Subtypes of FSGS were as follows; not otherwise specified (NOS; n=8), collapsing (n=5), cellular (n=2), and perihilar (n=2). Conclusion: Secondary FSGS was observed in 14.5% of biopsies of renal allograft recipients and seemed no significant impact on allograft survival.

Outcome of living donor renal allograft survival in children with focal segmental glomerulosclerosis

2009 ◽  
Vol 13 (1) ◽  
pp. 39-43
Author(s):  
Hasan Otukesh ◽  
Rozita Hoseini ◽  
Seyed-Mohammad Fereshtehnejad ◽  
Ashkan Heshmatzade Behzadi ◽  
Majid Chalian ◽  
...  
Keyword(s):  
Focal Segmental Glomerulosclerosis ◽  
Living Donor ◽  
Renal Allograft ◽  
Allograft Survival ◽  
Segmental Glomerulosclerosis

scholarly journals Treatment of Focal Segmental Glomerulosclerosis Recurrence in the Renal Allograft: A Report of Two Cases

2016 ◽  
Vol 6 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Minh-Ha Tran ◽  
Cynthia Chan ◽  
Whitney Pasch ◽  
Philip Carpenter ◽  
Hirohito Ichii ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Focal Segmental Glomerulosclerosis ◽  
Renal Allograft ◽  
Therapeutic Plasma Exchange ◽  
Spot Urine ◽  
Segmental Glomerulosclerosis ◽  
Glomerular Lesions ◽  
Stage Renal Disease ◽  
End Stage

Focal segmental glomerulosclerosis (FSGS) causes glomerular lesions that can progress to end-stage renal disease. It is suspected to be caused by a circulating factor that is amenable to plasmapheresis removal and exhibits a risk for recurrence in the renal allograft. We present two patients with FSGS recurrence in their allograft kidneys diagnosed by biopsy after significant proteinuria developed in the posttransplant setting. Treatment with therapeutic plasma exchange induced long-term remission in both patients. Spot urine protein:creatinine ratios were monitored and treatment was continued until a target of <0.5 was achieved. In patient number two, a second peak in proteinuria and azotemia was ultimately attributable to ureteral stenosis and these values normalized following repair. In conclusion, therapeutic plasma exchange is an effective treatment for FSGS recurring following renal transplant.

scholarly journals Loss of living donor renal allograft survival advantage in children with focal segmental glomerulosclerosis

2001 ◽  
Vol 59 (1) ◽  
pp. 328-333 ◽  
Author(s):  
Michelle A. Baum ◽  
Donald M. Stablein ◽  
Valerie M. Panzarino ◽  
Amir Tejani ◽  
William E. Harmon ◽  
...  
Keyword(s):  
Focal Segmental Glomerulosclerosis ◽  
Living Donor ◽  
Renal Allograft ◽  
Survival Advantage ◽  
Allograft Survival ◽  
Segmental Glomerulosclerosis

scholarly journals Improved renal allograft survival for pre-emptive paediatric renal transplant recipients in the UK

2021 ◽  
pp. archdischild-2020-321277
Author(s):  
Matko Marlais ◽  
Kate Martin ◽  
Stephen D Marks
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplant ◽  
Renal Allograft ◽  
Cox Regression ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Allograft Survival ◽  
Significant Difference ◽  
Donor Type ◽  
The Uk

BackgroundThe aim of this study was to investigate whether being on dialysis at the time of renal transplantation affected renal allograft survival in paediatric renal transplant recipients (pRTRs).MethodsRetrospective study of UK Transplant Registry (National Health Service Blood and Transplant) data on all children (aged <18 years) receiving a kidney-only transplant from 1 January 2000 to 31 December 2015. Kaplan-Meier estimates of patient and renal allograft survival calculated and Cox regression modelling accounting for donor type. The relationship between time on dialysis and renal allograft survival was examined.Results2038 pRTRs were analysed: 607 (30%) were pre-emptively transplanted, 789 (39%) and 642 (32%) on peritoneal dialysis and haemodialysis, respectively, at the time of transplantation. Five-year renal allograft survival was significantly better in the pre-emptively transplanted group (90.6%) compared with those on peritoneal dialysis and haemodialysis (86.4% and 85.7%, respectively; p=0.02). After accounting for donor type, there was a significantly lower hazard of 5-year renal allograft failure in pre-emptively transplanted children (HR 0.742, p=0.05). Time spent on dialysis pre-transplant negatively correlated with renal allograft survival (p=0.002). There was no significant difference in 5-year renal allograft survival between children who were on dialysis for less than 6 months and children transplanted pre-emptively (87.5% vs 90.5%, p=0.25).ConclusionsPre-emptively transplanted children have improved 5-year renal allograft survival, compared with children on dialysis at the time of transplantation. Although increased time spent on dialysis correlated with poorer renal allograft survival, there was no evidence that short periods of dialysis pre-transplant affected renal allograft survival.

Sign in / Sign up

Export Citation Format

Share Document