Demographics and response to therapeutic plasma exchange in pediatric renal transplantation for focal glomerulosclerosis: A single center experience

Shefali Mahesh, Marcela Del Rio, Dianne Feuerstein, Stuart M. Greenstein, Richard Schechner, Vivian Tellis, Frederick J. Kaskel

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Recurrence of FSGS following renal transplantation in pediatric patients is reported as 20-57%. Records of 37 pediatric patients transplanted for FSGS between 1990 and 2005 at a single center were reviewed. Recurrence of disease was assessed by nephrotic range proteinuria and/or FSGS on biopsy. Response to TPE was defined as urine protein to creatinine ratio <0.2. Forty-nine percent of patients were African American, 38% were Caucasian. Fifty-four percent received kidneys from deceased donors and 46% from live donors. Seven patients received preemptive TPE prior to transplantation. Two of these seven patients recurred in the transplanted kidney (28%). Recurrent FSGS occurred in 16 of 37 patients (46%), all of whom received TPE. Recurrence occurred within one month in 12 of 37 patients (32%); eight remitted with TPE (67%). Four of 12 patients failed to respond to TPE. Four of 37 patients (14%) recurred more than one month after transplantation and underwent TPE; three-fourths of patients remitted (75%). Twenty-one of 37 patients (54%) did not recur. One and five yr graft survivals were 84% and 67%, respectively. Median graft survival was 6.7 yr (5.2-10.3). Despite recurrence, FSGS patients can achieve sustained graft function.

Original languageEnglish (US)
Pages (from-to)682-688
Number of pages7
JournalPediatric Transplantation
Volume12
Issue number6
DOIs
StatePublished - Sep 2008

Fingerprint

Focal Segmental Glomerulosclerosis
Plasma Exchange
Kidney Transplantation
Demography
Pediatrics
Therapeutics
Recurrence
Graft Survival
Transplantation
Tissue Donors
Kidney
Proteinuria
African Americans
Creatinine

Keywords

  • Children
  • Focal glomerulosclerosis
  • Recurrence
  • Renal transplantation
  • Therapeutic plasma exchange

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Demographics and response to therapeutic plasma exchange in pediatric renal transplantation for focal glomerulosclerosis : A single center experience. / Mahesh, Shefali; Del Rio, Marcela; Feuerstein, Dianne; Greenstein, Stuart M.; Schechner, Richard; Tellis, Vivian; Kaskel, Frederick J.

In: Pediatric Transplantation, Vol. 12, No. 6, 09.2008, p. 682-688.

Research output: Contribution to journalArticle

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