Double recurrence of FSGS after two renal transplants with complete regression after plasmapheresis and ACE inhibitors

Giuseppe Montagnino, Antonio Tarantino, Giovanni Banfi, Massimo Maccario, Laura Costamagna, Claudio Ponticelli

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)166-168
Number of pages3
JournalTransplant International
Volume13
Issue number2
DOIs
Publication statusPublished - Mar 2000

Keywords

  • ACE-inhibitors
  • Kidney transplantation
  • Plasmapheresis
  • Recurrence of focal segmental glomerular sclerosis

ASJC Scopus subject areas

  • Transplantation

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