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Long-Term Outcomes of Kidney Transplant Recipients with Primary Idiopathic Focal Segmental Glomerulosclerosis (FSGS).

D. Khadzhynov, F. Halleck, L. Lehner, E. Schrezenmeier, K. Budde, O. Staeck.

Nephrology, Charité
Universitaetsmedizin, Berlin, Germany

Meeting: 2017 American Transplant Congress

Abstract number: B165

Keywords: Graft survival, Recurrence

Session Information

Date: Sunday, April 30, 2017

Session Name: Poster Session B: Kidney Complications II

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall D1

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Introduction:

Few data exists analyzing recurrence rates, treatment response and long-term outcomes in kidney transplant recipients (KTR) with primary FSGS.

Methods:

This retrospective observational study included 1218 consecutive KTR 2002-2016. All patients with primary idiopathic FSGS were identified applying strict diagnostic criteria. Outcomes were followed over an average of 70.4 months.

Results:

We identified 48 KTR (3.9%) with primary FSGS. 7-year death-censored graft survival was 81% (primary FSGS) vs. 85% (control), p=0.297 (Fig.1a). Among KTR with primary FSGS, 18 KTR experienced FSGS-recurrence (predicted incidence 50% after 7-years; Fig.1b). 7-year graft survival in KTR with FSGS-recurrence was significantly worse than in FSGS-KTR without recurrence (63% vs. 96%, p=0.010; Fig.1c).In case of FSGS recurrence a multimodal treatment approach was applied, including: plasma exchange (PE) (100% of patients), cyclosporine i.v. (50%), rituximab (61%) and the “multiple target treatment” according to Canaud et al. (AJT 2009) (39%). The median number of PE-sessions was 27. Proteinuria decreased significantly and persistently during the course of treatment (Fig.1d). Complete remission of FSGS was observed in 7 patients (39%), another 7 patients (39%) developed partial remission (PE-dependence observed in 4 patients (22%)). 4 patients (22%) with FSGS recurrence experienced early graft loss (< 6 months post-transplant) despite all treatment efforts.

Conclusions:

In KTR with primary FSGS a high proportion of recurrences occurred during the long-term follow-up and led to significantly worse graft survival. However, a multimodal treatment approach mostly resulted in resolving of proteinuria and full or partial remission. Graft survival in KTR with underlying primary FSGS was comparable with the control group.

CITATION INFORMATION: Khadzhynov D, Halleck F, Lehner L, Schrezenmeier E, Budde K, Staeck O. Long-Term Outcomes of Kidney Transplant Recipients with Primary Idiopathic Focal Segmental Glomerulosclerosis (FSGS). Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Khadzhynov D, Halleck F, Lehner L, Schrezenmeier E, Budde K, Staeck O. Long-Term Outcomes of Kidney Transplant Recipients with Primary Idiopathic Focal Segmental Glomerulosclerosis (FSGS). [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-outcomes-of-kidney-transplant-recipients-with-primary-idiopathic-focal-segmental-glomerulosclerosis-fsgs/. Accessed January 16, 2021.

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