2015年5月25日星期一

High Risk of FSGS Relapse after A Kidney Transplant

"It is my daughter Joan, she is 23 years old that has the FSGS disease from 2008 and she had transplant done on November 30, 2011. But, the doctor said after two days of transplant that the FSGS is back. Her creatinine is 220 right now and she is doing plasma exchange three times a week. Is there anyway that can help us get rid of the disease?"

FSGS is one of the major primary kidney diseases that cause end stage renal disease requiring dialysis or a kidney transplant. A major problem of patients with this disease receiving a transplant is a very high risk for relapse of FSGS leading to loss of the transplanted organ.

Though the mortality rate associated with ESRD can be partially improved by kidney transplant, lots of patients with FSGS tend to lose the transplanted organ due to the relapse of this disorder. Actually, relapse rates as high as 80% has been reported.

Characteristics of FSGS include:

▪ There are some scars on the kidney, but only some glomeruli become scared.

▪ Urine Protein is the common presentation.

▪ In most cases, patients will develop into Renal Failure in 5~20 years. However, for those with serious illness condition, this period only need 2~3 years.

Is there any way to get rid of FSGS?

As a kind of immune disease, it is mediated by immune cells. The infiltration T cells in the glomeruli attack the renal intrinsic cells directly or damage the epithelial cells by releasing vascular permeability factors.

The immune disorder will lead to over reaction of immune system. The immune complex will stay in the blood circulation and deposit on other organs. Massive depositions of immune complexes on the glomerular basement membrane will lead to the proliferation and swelling of mesangial cells, thus impairing the glomeruli filtrating barrier.


To get rid of this disease, patients with FSGS need to control the excessive immune reaction. Moreover, removing the immune complex and restoring the kidney function can help us avoid the relapse.

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