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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 71 No. 4, 2017.

Professional paper

KIDNEY TRANSPLANTATION IN PATIENTS WITH FOCAL SEGMENTAL GLOMERULOSCLEROSIS

LEA KATALINIĆ ; University Hospital Centre Zagreb, Department of Nephrology, Arterial hypertension, Dialysis and Transplantation,Zagreb, Croatia
LANA GELLINEO ; University Hospital Centre Zagreb, Department of Nephrology, Arterial hypertension, Dialysis and Transplantation,Zagreb, Croatia
MARIJANA ĆORIĆ ; University of Zagreb, School of Medicine,University Hospital Centre Zagreb, Department of Pathology, Zagreb, Croatia
NIKOLINA BAŠIĆ orcid id orcid.org/0000-0002-0221-2758 ; University Hospital Centre Zagreb, Department of Nephrology, Arterial hypertension, Dialysis and Transplantation, University of Zagreb, School of Medicine, Zagreb, University of Osijek, School of Medicine, Osijek, Croatia

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Abstract

Aims: Posttransplant recurrence of FSGS remains an obstacle towards satisfactory long-term kidney allograft survival. We aimed to evaluate the outcomes of kidney transplantation (KTx) in patients with FSGS treated at our Center and discuss available management options for improved outcomes in this group of patients. Patients and Methods: All patients (n=30; 33.3% male) with histological evidence of FSGS on a native kidney biopsy transplanted during the period between October
2007 and October 2013 were analyzed. Data were obtained from the medical records and charts. Results: 29 patients had a non-collapsing FSGS (ncFSGS), while one had collapsing FSGS (cFSGS). 96.7% of patients received deceased donor kidney allograft. Overall patient survival was 90% during the follow-up period. 80% of patients had satisfactory allograft function, with median allograft survival of 49.15 (range, 0.5-84) months. The incidence of recurrence was 20% (6/30), with 3 allografts lost rapidly due to cFSGS. cFSGS group had higher urine protein excretion earlier in the posttransplant period (P < 0.05), which resulted with more severe clinical presentation and early allograft loss (3-6 months posttransplant). Therapeutic plasma exchange (TPE) was successfully employed in 2 patients with ncFSGS, while 2 patients in the cFSGS group did not respond to treatment (response rate 50%). Conclusion: Although an increased risk of recurrence exists, KTx remains the treatment of choice for patients with FSGS. Immediate allograft biopsy should be performed in all patients developing proteinuria and prompt therapy should be started in order to achieve better outcomes.

Keywords

focal segmental glomerulosclerosis; kidney transplantation; outcome

Hrčak ID:

193709

URI

https://hrcak.srce.hr/193709

Publication date:

15.2.2018.

Article data in other languages: croatian

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