TY - JOUR
T1 - Demographics and response to therapeutic plasma exchange in pediatric renal transplantation for focal glomerulosclerosis
T2 - A single center experience
AU - Mahesh, Shefali
AU - Del Rio, Marcela
AU - Feuerstein, Dianne
AU - Greenstein, Stuart
AU - Schechner, Richard
AU - Tellis, Vivian
AU - Kaskel, Frederick
PY - 2008/9
Y1 - 2008/9
N2 - 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.
AB - 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.
KW - Children
KW - Focal glomerulosclerosis
KW - Recurrence
KW - Renal transplantation
KW - Therapeutic plasma exchange
UR - http://www.scopus.com/inward/record.url?scp=49349106248&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=49349106248&partnerID=8YFLogxK
U2 - 10.1111/j.1399-3046.2007.00880.x
DO - 10.1111/j.1399-3046.2007.00880.x
M3 - Article
C2 - 18282212
AN - SCOPUS:49349106248
SN - 1397-3142
VL - 12
SP - 682
EP - 688
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 6
ER -