Plasmapheresis treatment for recurrent focal sclerosis in pediatric renal allografts

S. M. Greenstein, M. Delrio, E. Ong, D. Feuerstein, R. Schechner, D. Kim, H. Corey, R. Kaskel, V. A. Tellis, M. L. Moritz

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Recurrence of focal segmental glomerulosclerosis (FSGS) in pediatric renal allografts is associated with a poor graft survival. This study reports on plasmapheresis for the treatment of recurrent FSGS in pediatric renal transplant recipients. The records of 100 consecutive pediatric (age <21 years) renal transplants were reviewed. Twenty patients had FSGS as the cause of renal failure. Eight of these (40%) had a recurrence (proteinuria >1 g/m2 per day) within 1 month of transplantation. Five of six patients treated with plasmapheresis went into remission (<0.2 g/m2 per day), receiving a total of 42±26 (12-73) sessions, with the mean number of sessions required to achieve a remission being 24±17 (8-51). One patient had a second recurrence 1 year following cessation of plasmapheresis and responded to another course of plasmapheresis. The 1 patient who did not respond to plasmapheresis had a delay in initiation of therapy of 42 days. Plasmapheresis initiated within 48 h of recurrence resulted in earlier remissions and improved graft survival among our patients. Plasmapheresis appears to be effective in treating recurrent FSGS following kidney transplantation and should be started as soon as possible. The number of plasmapheresis sessions used to achieve remission should be adjusted according to response rather than adhering to a fixed protocol.

Original languageEnglish (US)
Pages (from-to)1061-1065
Number of pages5
JournalPediatric Nephrology
Issue number12
StatePublished - 2000


  • Focal sclerosis
  • Nephrotic syndrome
  • Plasmapheresis
  • Proteinuria
  • Recurrence
  • Renal transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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