Multiple-target Therapy for Posttransplant Focal Segmental Glomerulosclerosis.

Autor:	Mansur J; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Chang-Dávila D; Universidade Peruana Cayetano Heredia, Lima, Peru., Simões MG; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Cristelli MP; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil., Stopa Martins SB; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil., de Sousa Proença HM; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil., Viana LA; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil., Ferreira AN; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil., Doher MP; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Medina-Pestana J; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Mastroianni Kirsztajn G; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil., Tedesco-Silva H; Nephrology Division, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.; Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2024 May 28; Vol. 10 (6), pp. e1651. Date of Electronic Publication: 2024 May 28 (Print Publication: 2024).
DOI:	10.1097/TXD.0000000000001651
Abstrakt:	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. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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