ISSN:
1432-2277
Keywords:
Key words Recurrence of focal segmental glomerular sclerosis
;
Kidney transplantation
;
Plasmapheresis
;
ACE-inhibitors
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract A patient who had undergone a first cadaveric donor kidney transplantation for idiopathic focal segmental glomerular sclerosis (FSGS), had an immediate recurrence of a biopsy-proven FSGS that eventually led to graft failure within 5 years from transplantation. The patient underwent a second cadaveric transplantation 10 months later. An immediate recurrence of a biopsy-proven FSGS occurred that was treated with two protracted cycles of plasmapheresis of seven months each, with the addition of an ACE inhibitor from the beginning. A complete and stable remission of FSGS was observed, which continues after more than 6 years from the end of plasmapheresis. The recurrence of FSGS after a second transplantation has a poor prognosis, but prolonged plasmapheresis treatment, by removing circulating factors altering glomerular permselectivity, and the addition of ACE inhibitors, through their potential interference with TGF-β, might be synergistic in obtaining permanent remission.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001470050316
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