DOI QR코드

DOI QR Code

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

  • Park, Hoon Suk (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Hong, Yuah (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Sun, In O (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Chung, Byung Ha (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Hyung Wook (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Choi, Bum Soon (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Park, Cheol Whee (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Jin, Dong Chan (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Yong Soo (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Yang, Chul Woo (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • Received : 2013.07.09
  • Accepted : 2013.09.23
  • Published : 2014.07.01

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.

Keywords

References

  1. Hariharan S, Adams MB, Brennan DC, et al. Recurrent and de novo glomerular disease after renal transplantation: a report from Renal Allograft Disease Registry (RADR). Transplantation 1999;68:635-641. https://doi.org/10.1097/00007890-199909150-00007
  2. Hickson LJ, Gera M, Amer H, et al. Kidney transplantation for primary focal segmental glomerulosclerosis: outcomes and response to therapy for recurrence. Transplantation 2009;87:1232-1239. https://doi.org/10.1097/TP.0b013e31819f12be
  3. Choi KH, Kim SI, Yoon SY, et al. Long-term outcome of kidney transplantation in adult recipients with focal segmental glomerulosclerosis. Yonsei Med J 2001;42:209-214. https://doi.org/10.3349/ymj.2001.42.2.209
  4. Pardon A, Audard V, Caillard S, et al. Risk factors and outcome of focal and segmental glomerulosclerosis recurrence in adult renal transplant recipients. Nephrol Dial Transplant 2006;21:1053-1059. https://doi.org/10.1093/ndt/gfk005
  5. Hwang JH, Han SS, Huh W, et al. Outcome of kidney allograft in patients with adulthood-onset focal segmental glomerulosclerosis: comparison with childhood-onset FSGS. Nephrol Dial Transplant 2012;27:2559-2565. https://doi.org/10.1093/ndt/gfr699
  6. Salomon R, Gagnadoux MF, Niaudet P. Intravenous cyclosporine therapy in recurrent nephrotic syndrome after renal transplantation in children. Transplantation 2003;75:810-814. https://doi.org/10.1097/01.TP.0000055215.20367.21
  7. Raafat RH, Kalia A, Travis LB, Diven SC. High-dose oral cyclosporin therapy for recurrent focal segmental glomerulosclerosis in children. Am J Kidney Dis 2004;44:50-56. https://doi.org/10.1053/j.ajkd.2004.03.028
  8. Savin VJ, Sharma R, Sharma M, et al. Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis. N Engl J Med 1996;334:878-883. https://doi.org/10.1056/NEJM199604043341402
  9. Laufer J, Ettenger RB, Ho WG, Cohen AH, Marik JL, Fine RN. Plasma exchange for recurrent nephrotic syndrome following renal transplantation. Transplantation 1988;46:540-542. https://doi.org/10.1097/00007890-198810000-00014
  10. Andresdottir MB, Ajubi N, Croockewit S, Assmann KJ, Hibrands LB, Wetzels JF. Recurrent focal glomerulosclerosis: natural course and treatment with plasma exchange. Nephrol Dial Transplant 1999;14:2650-2656. https://doi.org/10.1093/ndt/14.11.2650
  11. Gohh RY, Yango AF, Morrissey PE, et al. Preemptive plasmapheresis and recurrence of FSGS in high-risk renal transplant recipients. Am J Transplant 2005;5:2907-2912. https://doi.org/10.1111/j.1600-6143.2005.01112.x
  12. Canaud G, Zuber J, Sberro R, et al. Intensive and prolonged treatment of focal and segmental glomerulosclerosis recurrence in adult kidney transplant recipients: a pilot study. Am J Transplant 2009;9:1081-1086. https://doi.org/10.1111/j.1600-6143.2009.02580.x
  13. Ohta T, Kawaguchi H, Hattori M, et al. Effect of preand postoperative plasmapheresis on posttransplant recurrence of focal segmental glomerulosclerosis in children. Transplantation 2001;71:628-633. https://doi.org/10.1097/00007890-200103150-00008
  14. Stewart ZA, Shetty R, Nair R, Reed AI, Brophy PD. Case report: successful treatment of recurrent focal segmental glomerulosclerosis with a novel rituximab regimen. Transplant Proc 2011;43:3994-3996. https://doi.org/10.1016/j.transproceed.2011.10.051
  15. Jeon JM, Oh JS, Kim SM, et al. Combination treatment of rituximab and plasmapheresis in acute cellular rejection with focal segmental glomerular sclerosis after renal transplantation. J Korean Soc Transplant 2010;24:30-34. https://doi.org/10.4285/jkstn.2010.24.1.30
  16. Nam JY, Choi AS, Kim SJ, et al. Rituximab and plasmapheresis for post-transplant recurrence of FSGS. Korean J Nephrol 2010;29:292-295.
  17. Dello Strologo L, Guzzo I, Laurenzi C, et al. Use of rituximab in focal glomerulosclerosis relapses after renal transplantation. Transplantation 2009;88:417-420. https://doi.org/10.1097/TP.0b013e3181aed9d7
  18. Rodriguez-Ferrero M, Ampuero J, Anaya F. Rituximab and chronic plasmapheresis therapy of nephrotic syndrome in renal transplantation patients with recurrent focal segmental glomerulosclerosis. Transplant Proc 2009;41:2406-2408. https://doi.org/10.1016/j.transproceed.2009.06.044
  19. Audard V, Kamar N, Sahali D, et al. Rituximab therapy prevents focal and segmental glomerulosclerosis recurrence after a second renal transplantation. Transpl Int 2012;25:e62-e66. https://doi.org/10.1111/j.1432-2277.2012.01462.x
  20. Fornoni A, Sageshima J, Wei C, et al. Rituximab targets podocytes in recurrent focal segmental glomerulosclerosis. Sci Transl Med 2011;3:85ra46.
  21. Cibrik DM, Kaplan B, Campbell DA, Meier-Kriesche HU. Renal allograft survival in transplant recipients with focal segmental glomerulosclerosis. Am J Transplant 2003;3:64-67.
  22. Ryu HJ, Park EC, Sohn TY, Yu SH. Hospital staff and patient recognition toward opening of medical services market, and factors in selecting a foreign hospital. Yonsei Med J 2007;48:184-191. https://doi.org/10.3349/ymj.2007.48.2.184
  23. Baum MA, Stablein DM, Panzarino VM, Tejani A, Harmon WE, Alexander SR. Loss of living donor renal allograft survival advantage in children with focal segmental glomerulosclerosis. Kidney Int 2001;59:328-333. https://doi.org/10.1046/j.1523-1755.2001.00494.x

Cited by

  1. Focal segmental glomerular sclerosis recurrence with massive proteinuria and anuria immediately after kidney transplantation vol.20, pp.suppl2, 2014, https://doi.org/10.1111/nep.12455
  2. Update on the treatment of focal segmental glomerulosclerosis in renal transplantation vol.6, pp.1, 2016, https://doi.org/10.5500/wjt.v6.i1.54
  3. Treatment of Focal Segmental Glomerulosclerosis Recurrence in the Renal Allograft: A Report of Two Cases vol.6, pp.1, 2014, https://doi.org/10.1159/000445428
  4. Decreased Expression of MicroRNA-107 in B Lymphocytes of Patients with Antibody-Mediated Renal Allograft Rejection vol.246, pp.2, 2018, https://doi.org/10.1620/tjem.246.87
  5. Clinical impact of complement (C1q, C3d) binding De Novo donor-specific HLA antibody in kidney transplant recipients vol.13, pp.11, 2014, https://doi.org/10.1371/journal.pone.0207434
  6. Therapeutic Options for Recurrence of Primary Focal Segmental Glomerulonephritis (FSGS) in the Renal Allograft: Single-Center Experience vol.10, pp.3, 2021, https://doi.org/10.3390/jcm10030373
  7. Rituximab or plasmapheresis for prevention of recurrent focal segmental glomerulosclerosis after kidney transplantation: A systematic review and meta-analysis vol.11, pp.7, 2021, https://doi.org/10.5500/wjt.v11.i7.303
  8. Recurrent Focal Segmental Glomerulosclerosis After Kidney Transplantation in African Americans: Review of the Current Evidence vol.19, pp.12, 2014, https://doi.org/10.6002/ect.2020.0542
  9. Management of recurrent focal segmental glomerulosclerosis (FSGS) post renal transplantation vol.36, pp.1, 2014, https://doi.org/10.1016/j.trre.2021.100675
  10. Kidney Transplantation for Focal Segmental Glomerulosclerosis: Can We Prevent Its Recurrence? Personal Experience and Literature Review vol.11, pp.1, 2014, https://doi.org/10.3390/jcm11010093