Background and aim of the study: Post-transplant FSGS is a major risk factor for graft loss. We therefore aimed to assess patients with FSGS in our cohort of kidney transplant recipients.
Patients and methods: In this retrospective study that aimed to investigate glomerular disease recurrence post-transplantation. Kidney transplant recipients (KTR) were screened for the diagnosis of FSGS between 1996 and 2023 and details were recorded about the transplant, clinical outcomes, treatments, and other risk factors.
Results: Among 3670 KTR screened for FSGS, 106 were identified to have FSGS as original kidney disease. Of them, 52 had a diagnosis of idiopathic FSGS. Most of the patients were Kuwaiti males who received their grafts from living donors (84.9%). Prophylactic plasma exchange (PE) was performed in 19 (38%). All patients were maintained on CNI based triple immunosuppression. FSGS recurrence was confirmed in 10 patients (17.5%). PE and rituximab were the most frequent treatment options (7 out of 10 patients received PE and rituximab) and 4 patients had recurrence despite prophylactic PE and rituximab. The remaining patients were managed by anti-proteinuric agents. At one year follow-up, complete remission was observed in 5 patients while the remaining showed partial remission. Two patients lost their grafts within 2 years while the remaining 8 are enjoying stable graft function. Patient or graft outcomes were comparable between primary and secondary FSGS cases(P>0.05).
Conclusions: Lower rate of recurrence of idiopathic FSGS in our cohort (15.3 %) and the comparable patient and graft outcomes might be due to the optimised immunosuppressive regimen.