ESPN 51th Annual Meeting

ESPN 2018


 
TRANSPLANTATION IN FSGS: A MULTICENTRIC STUDY FROM TURKEY
MUSTAFA KOYUN 1 SEMA AKMAN 1 ELIF COMAK 1 SEVCAN BAKKALOGLU 2 GÖNÜL PARMAKSIZ 11 CANER ALPARSLAN 3 HAKAN POYRAZOGLU 5 NUR CANPOLAT 4 AYSUN KARABAY BAYAZIT 6 ALI DELIBAS 7 NURDAN YILDIZ 8 GÜL OZCELIK 9 ELIF BAHAT OZDOGAN 10

1- AKDENIZ UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ANTALYA, TURKEY
2- GAZI UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ANKARA, TURKEY
3- TEPECIK HOSPITAL, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, IZMIR, TURKEY
4- CERRAHPASA UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ISTANBUL, TURKEY
5- ERCIYES UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, KAYSERI, TURKEY
6- CUKUROVA UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ADANA, TURKEY
7- MERSIN UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, MERSIN, TURKEY
8- MARMARA UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ISTANBUL, TURKEY
9- SISLI ETFAL HOSPITAL, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ISTANBUL, TURKEY
10- KARADENIZ TEKNIK UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, TRABZON, TURKEY
11- BASKENT UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ADANA, TURKEY
 
Introduction:

Focal Segmental Glomerulosclerosis (FSGS) had high recurrence rate after kidney transplantation (tx). Conflicting results exist about the efficiency of pre-transplant plasmapheresis (PP) to prevent FSGS recurrence. So, policy regarding PP differs from one center to another. We aimed to search for the effect of PP on FSGS recurrence in pediatric kidney transplant recipients and also PP policy of transplant centers at our country.

Material and methods:

Questionnaire regarding the policy of PP and experience of kidney tx of children with FSGS was sent to transplant centers in Turkey. Eleven centers responded.

Results:

A total of 89 children with FSGS (10.2%) within a total number of 874 kidney transplants were included. 70 (78.7%) of transplants had living-related donors. 34 (38.2%) had genetic mutations leading to FSGS (mainly podocin mutations). 14 (15.3%) patients underwent pre-transplant plasmapheresis. Early recurrence (within first month of tx) developed in 13 patients (14.6%); recurrence rate was 21.8% when patients with genetic FSGS were excluded. Pre-transplant plasmapheresis was not found to be effective to prevent early FSGS recurrence (recurrence rate: 35.7% vs 10.6 % in patients with and without plasmapheresis, respectively, NS).

Conclusions:

We found that pre-transplant plasmapheresis was ineffective to prevent early recurrence. There is a need of consensus for the use of pre-transplant plasmapheresis to prevent FSGS recurrence in pediatric renal transplantation.