Skip Navigation

This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (12)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Newstead, C. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Newstead, C. G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Nephrol Dial Transplant (2003) 18: VI68-VI74
© 2003 European Renal Association-European Dialysis and Transplant Association

Recurrent disease in renal transplants

Chas G. Newstead

Department of Renal Medicine, St James’s University Hospital, Leeds, UK

Correspondence and offprint requests to: Dr C. G. Newstead, MD, Consultant Renal Physician, Department of Renal Medicine, St James’s University Hospital, Leeds, UK.

Abstract

Histology compatible with minimal change glomerulonephritis and associated with nephrotic syndrome has been reported as an occasional curiosity post-renal transplantation. Focal segmental glomerulosclerosis (FSGS) has a recurrence rate of ~20%. Age <15 years, an aggressive clinical course of the original disease and diffuse mesangial proliferation on native biopsy, are considered predictive of relapse. At present there are no tests that can accurately predict the likelihood of recurrence. Data from paediatric patients whose primary disease was FSGS were, on average, 90% more likely to lose a graft from a live donor and 50% more likely to lose a graft from a cadaveric donor compared with recipients with structural disorders. Recurrence in a subsequent graft is expected if the first graft was affected, but not if the first graft did not demonstrate recurrence. The best-established and most effective treatment of recurrent disease requires both plasma exchange and cyclophosphamide. Familial focal and segmental glomerulosclerosis, although rare, is important to recognize, as it is a different syndrome to idiopathic FSGS of childhood and overall transplant survival is good. Adults with ‘secondary’ FSGS would not be expected to be at risk of recurrent disease in a renal transplant.

Keywords: FSGS; recurrent disease; renal transplantation


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.