当前位置： SCI文献检索 > PEDIATRIC TRANSPLANTATION期刊下所有文献 > Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation.

Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation.

Abstract：

: FSGS has a high recurrence rate after renal transplantation. To examine the effects of the use of preemptive and post-transplant PP on recurrence and graft outcome, we conducted a retrospective study on 34 pediatric patients (mean age 13±5 yr) with biopsy-proven pretransplant FSGS and who underwent a renal transplantation between 1996 and 2007. Recurrence was defined as a serum albumin level of <3.0g/L in the presence of nephrotic-range proteinuria (>40mg/m(2) /h). Total response to PP therapy was defined as the resolution of the nephrotic-range proteinuria and partial response as persistent proteinuria despite PP but not in the nephrotic range. Fifteen patients received a LD renal transplantation and 19 patients received a DD renal transplantation. Nineteen patients received CsA and 14 patients received tacrolimus. Nineteen patients (56%) had FSGS recurrence. There was no difference in the recurrence rate between patients receiving CsA vs. tacrolimus. Among the 15 LD patients, 13 received preemptive PP (1-10 sessions) and seven patients (47%) had subsequent FSGS recurrence. Among the 19 DD patients, four received preemptive PP and 12 (63%) had FSGS recurrence. The number of preemptive PP did not affect the recurrence rate. In a group of patients with a previous graft loss secondary to recurrence, the rate of recurrence was lower than expected (40%) and two of the three patients who did not recur had three or more sessions of preemptive PP. Of the 19 patients with recurrence, 17 were treated with PP therapy and 88% of the patients fully or partially responded. Only five patients had graft loss at three yr post-transplant: two from FSGS recurrence and three from non-compliance. These results suggest that preemptive PP does not decrease the rate of recurrence after transplantation but might be beneficial in treating high-risk patients with documented recurrence. Patients with FSGS recurrence post-transplant can achieve good graft survival with both LD and DD transplantation.

journal_name

Pediatr Transplant

journal_title

Pediatric transplantation

authors

Gonzalez E,Ettenger R,Rianthavorn P,Tsai E,Malekzadeh M

doi

10.1111/j.1399-3046.2011.01478.x

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

495-501

issue

eissn

1397-3142

issn

1399-3046

journal_volume

pub_type

杂志文章

在线工具

Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation.