Recurrence of Focal Segmental Glomerulosclerosis in the Transplanted Kidney

Leumann, Ernst; Briner, J; Donckerwolcke, R. A.; Kuijten, R. H.; Largiadèr, F

doi:10.1159/000181755

Cited by 65 publications

(18 citation statements)

References 3 publications

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“…The rapid recurrence of proteinuria in some of these patients after transplantation has been noted in several recent reviews [6,7,10]. Multiple recurrences, as noted in this man, are very common if patients with recurrent disease receive subsequent transplants.…”

Section: Discussionsupporting

confidence: 52%

Plasmapheresis and Dipyridamole for Recurrent Focal Glomerular Sclerosis

Zimmerman¹

1985

Nephron

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A 38-year-old man had recurrence of nephrotic syndrome with focal glomerular sclerosis (FGS) in two consecutive cadaveric renal allografts. His first graft was lost to recurrent disease after 30 months. Because prior animal experiments performed when he had his first graft indicated a possible serum factor or factors capable of enhancing urine protein excretion, three plasmapheresis periods of 6–8 treatments each were performed 3,23 and 34 months after recurrence of FGS in the second graft. Urine protein excretion was decreased transiently in the first treatment period when the allograft biopsy revealed only glomerular foot process effacement. The second and third plasmapheresis treatment periods were performed after typical lesions of FGS were present in the graft and moderate renal insufficiency occurred. Dipyridamole was also given at this time. There has been associated stabilization of renal function for over 31 months. Prior to this, renal function was significantly (p < 0.001) decreasing with time. The reasons for stabilization of renal function in this man with recurrent FGS are not defined, but the results suggest the need to further evaluate plasmapheresis and the platelet inhibitor dipyridamole in native and recurrent FGS.

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Section: Discussionsupporting

confidence: 52%

Plasmapheresis and Dipyridamole for Recurrent Focal Glomerular Sclerosis

Zimmerman¹

1985

Nephron

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“…The incidence of recurrence of FSGS appears to be higher when the duration of the original disease is short [10,12,15]. Thus, our patients who underwent bilateral nephrectomies 14 and 29 months after the first appear ance of the nephrotic syndrome were at risk.…”

Section: Discussionmentioning

confidence: 83%

Recurrent Focal Segmental Glomerulosclerosis

Verani

Hawkins²

1986

Am J Nephrol

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We describe the early lesion of focal segmental glomerulosclerosis (FSGS) as it appeared in 2 cases of recurrent FSGS with early transplant nephrectomies (approximately 2 months) due to uncontrollable nephrotic syndrome. A quantitative evaluation showed that these lesions were present more often in the glomeruli of the juxtame-dullary cortex. Epithelial cell proliferation and detachment and foam cells were seen frequently and were considered the hallmarks of the early lesion of FSGS. Hyaline deposits are secondary late phenomena. We suggest that the glomerular foam cells in FSGS are mesangial in origin.

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“…Recurrence of idiopathic FSGS after renal transplantation has been reported with a prevalence of 6 4 0 % of cases in various series [2,4,7]. About a half of the patients with a recurrence lost their graft.…”

Section: Discussionmentioning

confidence: 99%

Double recurrence of FSGS after two renal transplants with complete regression after plasmapheresis and ACE inhibitors

Montagnino¹,

Tarantino²,

Banfi³

et al. 2000

Transplant Int

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A patient who had undergone a first cadaveric donor kidney transplantation for idiopathic focal segmental glomerular sclerosis (FSGS), had an immediate recurrence of a biopsy-proven FSGS that eventually led to graft failure within 5 years from transplantation. The patient underwent a second cadaveric transplantation 10 months later. An immediate recurrence of a biopsy-proven FSGS occurred that was treated with two protracted cycles of plasmapheresis of seven months each, with the addition of an ACE inhibitor from the beginning. A complete and stable remission of FSGS was observed, which continues after more than 6 years from the end of plasmapheresis. The recurrence of FSGS after a second transplantation has a poor prognosis, but prolonged plasmapheresis treatment, by removing circulating factors altering glomerular permselectivity, and the addition of ACE inhibitors, through their potential interference with TGF-0, might be synergistic in obtaining permanent remission.

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Recurrence of Focal Segmental Glomerulosclerosis in the Transplanted Kidney

Cited by 65 publications

References 3 publications

Plasmapheresis and Dipyridamole for Recurrent Focal Glomerular Sclerosis

Plasmapheresis and Dipyridamole for Recurrent Focal Glomerular Sclerosis

Recurrent Focal Segmental Glomerulosclerosis

Double recurrence of FSGS after two renal transplants with complete regression after plasmapheresis and ACE inhibitors

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