Nephrology Dialysis Transplantation, Vol 14, Issue 1 166-168, Copyright © 1999 by Oxford University Press
L Butani, M Polinsky, B Kaiser and H Baluarte
Background: Focal segmental glomerulosclerosis (FSGS)
is a leading cause of end-stage renal disease (ESRD) in children, and one
of the most difficult to manage because of its high recurrence rate
post-transplantation (Tx). Several predictive factors have been associated
with disease recurrence (DR) although one in particular, the role of
recipient race, has not been adequately evaluated. Herein we report our
experience with DR in the post-Tx period in eight patients.
Methods: Records were reviewed for all renal
transplants performed at St Christopher's Hospital for Children from
1971-1997. Results: Twenty patients received 27
allografts for ESRD due to FSGS. Ten (37%) grafts went to African-American
(AA) children, and 16 (59%) to those of Caucasian origin. DR was observed
in eight (30%) grafts after Tx. No differences were noted between the
patients who developed DR and those who did not, with respect to age at
diagnosis or time for ESRD. DR was observed in one (10%) of 10 grafts in
AA, compared to seven (41%) of 17 grafts in the other (O) racial groups
(P=0.19). At last follow-up, the only AA recipient with DR has maintained
stable renal function, while three (43%) of seven in O have lost their
grafts. Conclusions: In conclusion, in our population
post-Tx recurrence of FSGS occurred more frequently and presented a greater
threat to graft survival in O recipients than in those of AA descent.
Recipient race should therefore be taken into consideration during pre-Tx
counselling of families of children with FSGS. Key
words: FSGS; nephrotic syndrome; race; recurrence;
transplantation
ORIGINAL ARTICLES
Predictive value of race in post-transplantation recurrence of focal segmental glomerulosclerosis in children
Department of Pediatrics, Section of Nephrology, St Christopher's Hospital for Children, Erie Avenue at Font Street, Philadelphia, PA 19134-1034, USA; Corresponding author
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