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International Journal of Nephrology
Volume 2011, Article ID 506805, 9 pages
http://dx.doi.org/10.4061/2011/506805
Clinical Study

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

1Department of Pediatric Nephrology, Albert Einstein College of Medicine, Bronx, NY 10467, USA
2Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA
3Department of Pediatric Nephrology, Montefiore Medical Center, Bronx, NY 10467, USA
4Department of Pediatric Nephrology, Akron Children's Hospital, Akron, OH 44308, USA
5Department of Surgery and Transplantation, Montefiore Medical Center, Bronx, NY 10467, USA

Received 20 December 2010; Revised 8 March 2011; Accepted 14 April 2011

Academic Editor: James E. Springate

Copyright © 2011 Shimi Sharief et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 = . 7 5 . Recurrent FSGS is not associated with HLA mismatching, acute cellular or vascular rejection, and occurs primarily in the pediatric population.