Post-operative recurrence of focal segmental glomerulosclerosis according to pre-transplant treatment after kidney transplantation.

Abstract

BACKGROUND:

Recurrent focal segmental glomerulosclerosis (FSGS) after kidney transplantation (KT) is a serious complication and a significant risk factor for graft failure. However, there is no clear evidence of the effectiveness of pre-transplant treatment using plasmapheresis (PP) or rituximab in preventing post-operative FSGS recurrence after KT.

METHODS:

This single-center retrospective study included 99 adult patients with biopsy-proven primary FSGS who underwent KT between 2007 and 2018. The patients were divided into the pre-treatment group (N = 53, 53.5%) and no pre-treatment group (N = 46, 46.5%). In the pre-transplant group, prophylactic PP was administered before KT in patients undergoing living donor transplantation and the day after KT in those undergoing deceased donor transplantation.

RESULTS:

The rate of immediate post-operative recurrence was significantly higher in the no pre-treatment group (16 [34.8%]) than in the pre-treatment group (5 [9.4%]; P = 0.002). There were three cases of graft failure due to recurrent FSGS, all of which were in the no pre-treatment group. After adjusting for possible confounding factors, age (per 10-year increase; OR = 0.61, CI, 0.42-0.90; P = 0.012) and pre-transplant treatment (vs. no pre-transplant treatment; OR = 0.17, CI, 0.05-0.54; P = 0.003) were identified as significant factors associated with FSGS recurrence. The rate of death-censored graft survival was significantly superior in the pretransplant treatment group (P = 0.042).

CONCLUSION:

Pre-transplant treatment with PP was associated with beneficial effects on preventing FSGS recurrence after KT.

• Authors: Hye Eun Kwon, Young Hoon Kim, Sang Ah Lee, Jae Jun Lee, Youngmin Ko, Sung Shin, Joo Hee Jung, Frances S Sung, Chung Hee Baek, Hyosang Kim, Su-Kil Park, Hyunwook Kwon
• Journal: BMC nephrology (BMC Nephrol) Vol. 24 Issue 1 Pg. 53 (03 15 2023) ISSN: 1471-2369 [Electronic] England
• PMID: 36922759 (Publication Type: Journal Article)
• Copyright: © 2023. The Author(s).

Chemical References

• Rituximab

Topics

• Adult
• Humans
• Kidney Transplantation (adverse effects)
• Glomerulosclerosis, Focal Segmental (surgery, etiology)
• Retrospective Studies
• Rituximab
• Living Donors
• Plasmapheresis
• Recurrence