Kidney Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Kidney Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Recurrence of nephrotic syndrome/focal segmental glomerulosclerosis following renal transplantation in children.

Fine RN

School of Medicine, Stony Brook University, Stony Brook, NY 11794-8111, USA. richard.fine@stonybrook.edu

The incidence of recurrence of nephrotic syndrome/focal segmental glomerulosclerosis (NS/FSGS) is variable (~30%). The incidence of recurrence is less in African-Americans than in whites and Hispanics. Graft survival rates are decreased in recipients with FSGS, especially if remission of the NS is not achieved in those with recurrence. Although controversial, the use of living donor (LD) transplants are not contraindicated; however, obligatory heterozygote parental grafts with a podocin mutation should be used with caution. Optimal treatment to induce a remission post-transplant has not been delineated. Pre-transplant and/or prophylactic post-transplant pre-operative plasmapheresis (PP) for high-risk patients--especially those with recurrence in a previous graft--may be promising. An international multicenter controlled study is required to delineate the optimal approach to prevent and/or treat the recurrence of NS/FSGS.

Published 23 February 2007 in Pediatr Nephrol, 22(4): 496-502.
Full-text of this article is available online (may require subscription).

© 2004-2008 Kidney Transplant Research Today. All Rights Reserved.