Korean J Nephrol.  2010 Mar;29(2):292-295.

Rituximab and Plasmapheresis for Post-transplant Recurrence of FSGS

• Nam JY
• Choi AS
• Kim SJ
• Ji BH
• Oh JS
• Son YK
• Sin YH
• Kim JK
• Kim YJ

Abstract

Focal segmental glomerular sclerosis (FSGS) is known to recur in 20-40% of the renal allografts with graft loss in about half of these cases. We report a successful treatment of a recurrent FSGS after kidney transplantation with rituximab and plasmapheresis. An 16-year-old patient whose primary kidney disease was FSGS developed recurrence of proteinuria after living donor kidney transplantation despite preemptive plasmapheresis and one dose of rituximab (375 mg/m2). After kidney transplantation, nephrotic range proteinuria was detected. Kidney biopsy was done and showed recurrent FSGS. She undergone 11 times of plasmapheresis in the first 4 week post transplantation. In addition, she received additional one dose of rituximab (375 mg/m2) on day 14. Proteinuria was decreased below nephrotic range at 37 day. Ten months later, proteinuria was at 30 mg/day with excellent graft function. No significant adverse events related to rituximab or plasmapheresis were observed. Rituximab with plasmapheresis may be another option for recurrent FSGS after kidney transplantation.

Keyword

Focal segmental glomerulosclerosis; Rituximab; Kidney transplantation

MeSH Terms

Adolescent
Antibodies, Monoclonal, Murine-Derived
Biopsy
Glomerulosclerosis, Focal Segmental
Humans
Kidney
Kidney Diseases
Kidney Transplantation
Living Donors
Plasmapheresis
Proteinuria
Recurrence
Sclerosis
Transplantation, Homologous
Transplants
Rituximab
Antibodies, Monoclonal, Murine-Derived