Two case reports ofrecurrent focal segmental glomurular sclerosis after renal transplantation and preliminary application of risk grade assessment of circulating permeability factor panel / 中华器官移植杂志

ABSTRACT

Objective:To summarize the diagnosis, treatment and outcome of recurrent focal segmental glomurular sclerosis(FSGS)after kidney transplantation and explore the predictive value of risk grade assessment of peripheral circulating permeability factor for recurrent FSGS.Methods:Retrospective analysis was performed for pathological history, biopsy finding before and after transplantation, blood level of FSGS biomarkers of two patients with recurrent FSGS. Then the relationship was analyzed between the risk grade assessment of peripheral circulating permeability factor and recurrent FSGS.Results:Both patients belonged to primary FSGS with >10g/24h urine protein. The recurrence of FSGS after transplantation was confirmed by renal biopsy. After plasma exchange, rituximab and Tripterygium wilfordii, 24-hour urine protein content declined, general edema subsided significantly and renal function stabilized.Conclusions:After renal transplantation, plasma exchange and rituximab can effectively alleviate the symptoms of recurrent FSGS. And assessing risk level of peripheral circulating permeability factor panel may have value in predicting the recurrent risk of FSGS