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Joo, Lee, Lee, Kim, Kyu, Soo, Soon, and Yu: Clinical Characteristics of Focal Segmental Glomerulosclerosis Recurrence after Adult Renal Transplantation
Original Article

J Korean Soc Transplant 2010;24(2):87-92.

Published online: 10 June 2010

DOI: https://doi.org/10.4285/jkstn.2010.24.2.87

Clinical Characteristics of Focal Segmental Glomerulosclerosis Recurrence after Adult Renal Transplantation

Dong Jin Joo, M.D.1, 2, Jung Jun Lee, M.D.1, 2, Byung Mo Lee, M.D.1, 2, Myoung Soo Kim, M.D.1, 2, Ha Huh Kyu, M.D.1, 2, Jin Kim Soo, M.D.1, 2, Il Kim Soon, M.D.1, 2, Seun Kim Yu, M.D.1, 2

1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

2Research Institute for Transplantation, Yonsei University, Seoul, Korea

책임저자：김명수, 서울시 서대문구 신촌동 134연세대학교 의과대학 외과학교실, 120-752 Tel: 02-2228-2123, Fax: 02-313-8289 E-mail: ysms91@yuhs.ac

Copyright © 2010 The Korean Society for Transplantation

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Recurrence of focal segmental glomerulosclerosis (FSGS) after kidney transplantation is a frequent and still unpredictable complication. Moreover, risk factors for recurrence have not yet been clearly identified.

Methods

We enrolled into our study 2,882 adult kidney recipients who underwent transplantation between April 1979 and April 2009. We retrospectively reviewed clinical manifestations of recurrence of FSGS.

Results

Among the 2,784 adult renal recipients, forty four had undergone renal transplantation for primary FSGS. Of the 44, 12 (27.3%) showed recurrent FSGS. Mean duration between transplantation and FSGS recurrence was 22.8±37.4 months. There were no significant differences in patient characteristics in the recurrence and non-recurrence groups. The cumulative incidence of FSGS recurrence was 13.8% within 1 year after kidney transplantation and 23.2% within 3 years. The overall graft survival rate in the recurrence group was significantly lower than that of the non-recurrence group (P=0.0018) and non-FSGS group (P=0.0001). Graft failure happened more in the recurrence group (75%) than in the non-recurrence group (37.5%, P=0.042).

Conclusions

We failed to find any significant risk factors for FSGS recurrence after renal transplantation.

Keywords: Focal segmental glomerulosclerosis, Kidney transplantation, Risk factors, Recurrence

References

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Table 1.
Patient characteristics between FSGS non-recurrence group and recurrence group
Characteristics Non-recurrence Recurren ce P value
N 32 12  
Age, recipien t 30.5± 11.3 35.3± 14.7 0.253
Sex, recipien tm aleratio 22/32(68.8%) 9/12(75.0%) 0.733
Age, don or 33.5± 11.6 40.3± 10.4 0.067
Sex, don orm aleratio 22/32(68.8%) 8/12(66.7%) ＞0.9999
Don ortype      
LRD： LURD： Dec 18：14：0 6：5：1 0.399
DegreeofHLA m ism atch      
ABm ism atch 1.75± 0.80 1.67± 0.78 0.661
DRm ism atch 0.53± 0.51 0.83± 0.58 0.125
Retran splan tation      
Prim ary ： retran splan t 31：1 11：1 0.476
Main IS      
Aza： CsA ： Tac 1：29：2 0 ：9：3 0.250
Duration ofpre-tran splan t dialysis(m on ths) 19.14± 24.78 14.91± 22.92 0.675
In tervalFSGSdiagn osistotran splan tation (m on ths) 55.47± 50.16 79.08± 55.78 0.183
ARwithin 1 year      
No ： yes 20 ：12(37.5%) 6：6(50.0%) 0.411
Graftfailure 12(37.5%) 9(75.0%) 0.042

Abbreviations: FSGS, focalsegm en talglom erulosclerosis; LRD, livin grelateddon or; LURD, livin gun relateddon or; Dec, deceaseddon or; IS, im m un osuppressiveagen t; Aza, azathioprin e; CsA, cyclosporin eA; Tac, tacrolim us; AR, Acute rejection.

Table 2.
Causes of graft loss
Cause Non-recurren ce Recurren ce P value
(n = 12/32) (n = 9/12)
Acuterejection 8.3% 11.1%  
Chron icrejection 50.0% 22.2%  
In fection 8.3% 0  
Glom erulon ephritis 8.3% 33.3% 0.652
Others 8.3% 0  
Patien tdeath with 8.3% 22.2%  
fun ction in ggraft      
Cessation ofIS 8.3% 11.1%  

Abbreviation: IS, im m un osuppressiveagen t.

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