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Outcomes after renal transplantation for FSGS in children
Author(s) -
Baum Michelle A.
Publication year - 2004
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2004.00181.x
Subject(s) - medicine , transplantation , focal segmental glomerulosclerosis , acute tubular necrosis , dialysis , kidney transplantation , incidence (geometry) , end stage renal disease , surgery , disease , pediatrics , kidney , glomerulonephritis , physics , optics
Focal segmental glomerulosclerosis (FSGS) is the primary diagnosis resulting in end‐stage renal disease in approximately 12% of children receiving renal transplantation. Recurrent FSGS after transplantation is unpredictable and clear risk factors have not been identified. Post‐transplantation, the incidence of acute tubular necrosis requiring dialysis is higher in children with FSGS compared with other diagnoses and may represent immediate severe recurrence. Graft survival is decreased in children with FSGS compared with other primary diagnoses, and the impact is greatest in recipients of living donor transplants. Graft loss caused by recurrent FSGS is significantly higher in living donor transplants compared with cadaveric donor transplants in children. Compared with adults, the impact of FSGS on graft survival appears to be greatest in children. White recipient race is associated with a higher risk of graft loss from recurrent FSGS. Efforts to elucidate the mechanisms of recurrent FSGS and to understand risk factors based on genetics, potential circulating cytokines and permeability factors, age and race must move forward before we can significantly impact outcomes in renal transplantation for FSGS.