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.

scholarly journals Early Focal Segmental Glomerulosclerosis as a Cause of Renal Allograft Primary Nonfunction

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Emma J. Griffin ◽  
Peter C. Thomson ◽  
David Kipgen ◽  
Marc Clancy ◽  
Conal Daly
Keyword(s):  
Renal Transplantation ◽  
Acute Rejection ◽  
Focal Segmental Glomerulosclerosis ◽  
Renal Allograft ◽  
Recurrent Disease ◽  
Graft Function ◽  
Kidney Injury ◽  
Renal Allografts ◽  
Primary Nonfunction ◽  
Segmental Glomerulosclerosis

Background.Primary focal segmental glomerulosclerosis (FSGS) is one of the commonest causes of glomerular disease and if left untreated will often progress to established renal failure. In many cases the best treatment option is renal transplantation; however primary FSGS may rapidly recur in renal allografts and may contribute to delayed graft function. We present a case of primary nonfunction in a renal allograft due to biopsy-proven FSGS.Case Report.A 32-year-old man presented with serum albumin of 22 g/L, proteinuria quantified at 12 g/L, and marked peripheral oedema. Renal biopsy demonstrated tip-variant FSGS. Despite treatment, the patient developed progressive renal dysfunction and was commenced on haemodialysis. Cadaveric renal transplantation was undertaken; however this was complicated by primary nonfunction. Renal biopsies failed to demonstrate evidence of acute rejection but did demonstrate clear evidence of FSGS. The patient was treated to no avail.Discussion.Primary renal allograft nonfunction following transplantation is often due to acute kidney injury or acute rejection. Recurrent FSGS is recognised as a phenomenon that drives allograft dysfunction but is not traditionally associated with primary nonfunction. This case highlights FSGS as a potentially aggressive process that, once active in the allograft, may prove refractory to targeted treatment. Preemptive therapies in patients deemed to be at high risk of recurrent disease may be appropriate and should be considered.

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.

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 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.

scholarly journals Impact of preformed and de novo anti-HLA DP antibodies in renal allograft survival

2016 ◽  
Vol 34 ◽  
pp. 1-7 ◽  
Author(s):  
Dolores Redondo-Pachón ◽  
Julio Pascual ◽  
María J. Pérez-Sáez ◽  
Carmen García ◽  
Juan José Hernández ◽  
...  
Keyword(s):  
Renal Allograft ◽  
De Novo ◽  
Allograft Survival
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