Successful Management of Early Recurrent Focal Segmental Glomerulosclerosis after Renal Transplantation A Case Report and Brief Review of Literature

Focal segmental glomerulosclerosis (FSGS) recurs in 20 50 cases following transplantation and approximately half of these patients lose their grafts. We report a case of a 32-year-old man with idiopathic focal segmental glomerulosclerosis (FSGS) who underwent haploidentical live-related kidney transplantation with his 50-year-old mother as donor. He received induction with basiliximab and immunosuppression consisted of steroid, tacrolimus and mycophenolate mofetil (MMF). Two weeks after transplantation, patient presented with increasing creatinine and nephrotic range proteinuria. Renal allograft biopsy showed the histological features of FSGS in the graft by electron microscopy. He was treated with plasma exchange. Tacrolimus was continued and MMF was switched to oral cyclophosphamide. This resulted in remission of proteinuria from 9.9 to 0.91 g24hrs and stable graft function which are maintained at 6 months post transplant.