Recurrent Focal Segmental Glomerulosclerosis in Renal Allograft Recipients : Role of Human Leukocyte Antigen Mismatching and Other Clinical Variables

Abstract EN

Recurrence of focal segmental glomerulosclerosis (FSGS) after renal transplantation impacts long-term graft survival and limits access to transplantation.

We hypothesized that HLA donor/recipient matching could be used as a surrogate marker of recurrence.

In a retrospective study of 42 pediatric and 77 adult subjects with primary FSGS, transplanted from 1990 to 2007 at a single center, we analyzed the degree of donor/recipient HLA compatibility and other clinical variables associated with FSGS recurrence.

There were total of 131 allografts for primary FSGS (11 subjects were transplanted twice, and 1 had a third allograft) with 20 cases of FSGS recurrence (17 children) in the primary allograft, and two children who had FSGS recurrence in the second allograft.

Fifty-two subjects (40%) were African American, and 66 (50%) Caucasians.

Recurrent FSGS and controls were not different for age at transplant, gender, donor source, acute/chronic rejection episodes, and HLA matches.

Recurrent FSGS was not associated with HLA mismatches; power equals 83%.

Immunosuppressive regimen had no effect on recurrence of FSGS, P=.75.

Recurrent FSGS is not associated with HLA mismatching, acute cellular or vascular rejection, and occurs primarily in the pediatric population.