1. Multiple-target Therapy for Posttransplant Focal Segmental Glomerulosclerosis
- Author
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Juliana Mansur, MD, PhD, Domingo Chang-Dávila, MD, Marcela Giraldes Simões, MD, Marina Pontello Cristelli, MD, PhD, Suelen Bianca Stopa Martins, MD, Henrique Machado de Sousa Proença, MD, Laila Almeida Viana, MD, Alexandra Nicolau Ferreira, MD, PhD, Marisa Petrucelli Doher, MD, José Medina-Pestana, MD, PhD, Gianna Mastroianni Kirsztajn, MD, PhD, and Helio Tedesco-Silva, MD, PhD
- Subjects
Surgery ,RD1-811 - 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.
- Published
- 2024
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