Korean J Intern Med.  2014 Jul;29(4):482-488.

Effects of pretransplant plasmapheresis and rituximab on recurrence of focal segmental glomerulosclerosis in adult renal transplant recipients

• Park HS
• Hong Y
• Sun IO
• Chung BH
• Kim HW
• Choi BS
• Park CW
• Jin DC
• Kim YS
• Yang CW

Abstract

BACKGROUND/AIMS
Recurrent focal segmental glomerulosclerosis (FSGS) following renal transplantation is relatively common. However, the risk factors and optimal pretransplant treatment preventing recurrence of FSGS remain controversial.
METHODS
We retrospectively reviewed 27 adult renal transplant recipients with FSGS over a period of 10 years. We first compared possible risk factors for FSGS recurrence between the recurrence and nonrecurrence groups. Then we evaluated the effect of pretransplant plasmapheresis (PP; n = 4) and PP with rituximab (PP + RTX; n = 5) on recurrence of FSGS after transplantation compared to control patients that were not treated with these modalities.
RESULTS
There were seven recurrences in 27 patients (25.9%), but there were no significant differences in possible risk factors for FSGS recurrence between the two 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 pretransplant PP and PP + RTX groups (25% vs. 20%, p > 0.05).
CONCLUSIONS
Pretransplant PP or PP + RTX do not significantly decrease the recurrence of FSGS in adult renal transplant candidates.

Keyword

Rituximab; Plasmapheresis; Glomerulosclerosis, focal segmental; Recurrence; Kidney transplantation

MeSH Terms

Adult
Antibodies, Monoclonal, Murine-Derived/*administration & dosage
Female
Glomerulosclerosis, Focal Segmental/diagnosis/immunology/*surgery
Humans
Immunosuppressive Agents/*administration & dosage
*Kidney Transplantation/adverse effects
Male
Middle Aged
*Plasmapheresis
Recurrence
Retrospective Studies
Risk Factors
Treatment Outcome
Antibodies, Monoclonal, Murine-Derived
Immunosuppressive Agents