{"title":"Multiple-target Therapy for Posttransplant Focal Segmental Glomerulosclerosis.","authors":"Juliana Mansur, Domingo Chang-Dávila, Marcela Giraldes Simões, Marina Pontello Cristelli, Suelen Bianca Stopa Martins, Henrique Machado de Sousa Proença, Laila Almeida Viana, Alexandra Nicolau Ferreira, Marisa Petrucelli Doher, José Medina-Pestana, Gianna Mastroianni Kirsztajn, Helio Tedesco-Silva","doi":"10.1097/TXD.0000000000001651","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on the ideal strategy to treat posttransplant focal segmental glomerulosclerosis. The multiple-target therapy, which consisted of high-dose intravenous cyclosporine, prednisone, and plasmapheresis, showed favorable results.</p><p><strong>Methods: </strong>This single-center, prospective study sought to evaluate the multiple-target therapy in an independent cohort of patients.</p><p><strong>Results: </strong>Thirteen patients with posttransplant focal segmental glomerulosclerosis received multiple-target therapy. Complete remission was achieved in 2 patients (15.4%), and partial remission in another 2 patients (15.4%). Four patients (30.7%) did not show remission, and 5 patients (38%) lost the graft because of posttransplant focal segmental glomerulosclerosis during the 12-mo follow-up. Premature discontinuation of treatment occurred in 10 patients (77%), all associated with infectious adverse events. Cytomegalovirus was the most common complication, and preemptive therapy was used instead of prophylaxis.</p><p><strong>Conclusions: </strong>In this cohort of patients, the efficacy of the multiple-target therapy was poor and limited by the high incidence of infectious adverse events.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 6","pages":"e1651"},"PeriodicalIF":1.9000,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11139459/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation Direct","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/TXD.0000000000001651","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"TRANSPLANTATION","Score":null,"Total":0}
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Abstract
Background: There is no consensus on the ideal strategy to treat posttransplant focal segmental glomerulosclerosis. The multiple-target therapy, which consisted of high-dose intravenous cyclosporine, prednisone, and plasmapheresis, showed favorable results.
Methods: This single-center, prospective study sought to evaluate the multiple-target therapy in an independent cohort of patients.
Results: Thirteen patients with posttransplant focal segmental glomerulosclerosis received multiple-target therapy. Complete remission was achieved in 2 patients (15.4%), and partial remission in another 2 patients (15.4%). Four patients (30.7%) did not show remission, and 5 patients (38%) lost the graft because of posttransplant focal segmental glomerulosclerosis during the 12-mo follow-up. Premature discontinuation of treatment occurred in 10 patients (77%), all associated with infectious adverse events. Cytomegalovirus was the most common complication, and preemptive therapy was used instead of prophylaxis.
Conclusions: In this cohort of patients, the efficacy of the multiple-target therapy was poor and limited by the high incidence of infectious adverse events.
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