Bulut I K, Taner S, Keskinoglu A, Toz H, Sarsik B, Sezer T O, Kabasakal C
Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.
Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.
Transplant Proc. 2019 May;51(4):1064-1069. doi: 10.1016/j.transproceed.2019.01.096. Epub 2019 Feb 8.
Focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage renal disease in children. We analyzed the long-term outcome of pediatric patients with FSGS undergoing renal transplantation. The objective of the study is to report the experience of a single center and determine the incidence of recurrence, rejection, graft loss, and related risk factors.
This retrospective cohort study was performed between 1991 and 2018. Thirty patients with a pathologic diagnosis of primary FSGS were included in the study. The patients were diagnosed with FSGS according to histologic features in biopsies.
Twenty-one of the donors were deceased (70%) and 9 were alive (30%). FSGS recurred in only 2 patients. Graft loss occurred in 6 patients (20%). The causes of graft loss were chronic rejection in 4 patients and acute rejection in 2. Our graft survival rate was 100% at 1 year, 91% at 5 years, 80% at 10 years, 70% at 15 years, and 42% at 20 years. Five- and 10-year graft survival rates were 83% and 83% in living donors and 94% and 79% in deceased donors, respectively. According to Kaplan-Meier analysis, there was no statistically significant difference in terms of graft survival between living and deceased donors.
This study, with its contribution to literature in terms of long follow-up of FSGS patients from childhood to adulthood, is important. However, further studies are required.
局灶节段性肾小球硬化(FSGS)是儿童终末期肾病的常见病因。我们分析了接受肾移植的FSGS患儿的长期预后。本研究的目的是报告单一中心的经验,并确定复发、排斥反应、移植肾丢失及相关危险因素的发生率。
本回顾性队列研究于1991年至2018年进行。纳入30例经病理诊断为原发性FSGS的患者。患者根据活检的组织学特征诊断为FSGS。
供者中21例已死亡(70%),9例存活(30%)。仅2例患者出现FSGS复发。6例患者(20%)发生移植肾丢失。移植肾丢失的原因是4例慢性排斥反应和2例急性排斥反应。我们的移植肾1年存活率为100%,5年为91%,10年为80%,15年为70%,20年为42%。活体供者的5年和10年移植肾存活率分别为83%和83%,尸体供者分别为94%和79%。根据Kaplan-Meier分析,活体供者和尸体供者在移植肾存活方面无统计学显著差异。
本研究对FSGS患者从儿童到成人的长期随访资料丰富了文献,具有重要意义。然而,仍需要进一步研究。