Effects of pretransplant plasmapheresis and rituximab on recurrence of focal segmental glomerulosclerosis in adult renal transplant recipients
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Background/Aims: Recurrent focal segmental glomerulosclerosis (FSGS) followingrenal transplantation is relatively common. However, the risk factors andoptimal pretransplant treatment preventing recurrence of FSGS remain controversial. Methods: We retrospectively reviewed 27 adult renal transplant recipients withFSGS over a period of 10 years. We first compared possible risk factors for FSGSrecurrence between the recurrence and nonrecurrence groups. Then we evaluatedthe effect of pretransplant plasmapheresis (PP; n = 4) and PP with rituximab(PP + RTX; n = 5) on recurrence of FSGS after transplantation compared to controlpatients that were not treated with these modalities. Results: There were seven recurrences in 27 patients (25.9%), but there were nosignificant differences in possible risk factors for FSGS recurrence between thetwo groups. Recurrence rates between patients with pretransplant PP or PP +RTX and control patients were not significantly different (22.2% vs. 27.7%, p > 0.05). There was also no significant difference in recurrence between the pretransplantPP and PP + RTX groups (25% vs. 20%, p > 0.05). Conclusions: Pretransplant PP or PP + RTX do not significantly decrease the recurrenceof FSGS in adult renal transplant candidates.
Abstract
Background/Aims: Recurrent focal segmental glomerulosclerosis (FSGS) followingrenal transplantation is relatively common. However, the risk factors andoptimal pretransplant treatment preventing recurrence of FSGS remain controversial. Methods: We retrospectively reviewed 27 adult renal transplant recipients withFSGS over a period of 10 years. We first compared possible risk factors for FSGSrecurrence between the recurrence and nonrecurrence groups. Then we evaluatedthe effect of pretransplant plasmapheresis (PP; n = 4) and PP with rituximab(PP + RTX; n = 5) on recurrence of FSGS after transplantation compared to controlpatients that were not treated with these modalities. Results: There were seven recurrences in 27 patients (25.9%), but there were nosignificant differences in possible risk factors for FSGS recurrence between thetwo groups. Recurrence rates between patients with pretransplant PP or PP +RTX and control patients were not significantly different (22.2% vs. 27.7%, p > 0.05). There was also no significant difference in recurrence between the pretransplantPP and PP + RTX groups (25% vs. 20%, p > 0.05). Conclusions: Pretransplant PP or PP + RTX do not significantly decrease the recurrenceof FSGS in adult renal transplant candidates.
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