Recurrence of nephrotic syndrome/focal segmental glomerulosclerosis following renal transplantation in children.

Recurrence of nephrotic syndrome/focal segmental glomerulosclerosis following renal transplantation in children.
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DOI:
10.1007/s00467-006-0361-6
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发表时间:
2007-04
影响因子:
3
通讯作者:
Fine, Richard N.
Fine, Richard N.
中科院分区:
医学3区
文献类型:
--
作者:
Fine, Richard N.

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肾病综合征/局灶节段性肾小球硬化症 (NS/FSGS) 的复发率各不相同 (~30%) 非裔美国人的复发率低于白人和西班牙裔 FSGS 受者的移植物存活率降低,特别是如果复发者未达到 NS 缓解的情况 (LD) 移植没有禁忌症;然而,应谨慎使用具有 Podocin 突变的强制性杂合子亲本移植物 诱导移植后缓解的最佳治疗尚未确定 对于高危患者(尤其是先前移植物复发的患者),移植前和/或移植后预防性术前血浆置换 (PP) 可能是有希望的 一项国际多中心对照 需要进行研究来确定预防和/或治疗 NS/FSGS 复发的最佳方法
The incidence of recurrence of nephrotic syndrome/focal segmental glomerulosclerosis (NS/FSGS) is variable (~30%) The incidence of recurrence is less in African-Americans than in whites and Hispanics Graft survival rates are decreased in recipients with FSGS, especially if remission of the NS is not achieved in those with recurrence Although controversial, the use of living donor (LD) transplants are not contraindicated; however, obligatory heterozygote parental grafts with a podocin mutation should be used with caution Optimal treatment to induce a remission post-transplant has not been delineated Pre-transplant and/or prophylactic post-transplant pre-operative plasmapheresis (PP) for high-risk patients—especially those with recurrence in a previous graft—may be promising An international multicenter controlled study is required to delineate the optimal approach to prevent and/or treat the recurrence of NS/FSGS
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