Table 1.
Selected studies of prophylactic treatment before kidney transplantation in patients with primary FSGS
| Treatment | Study | Population | Design | Total (n) | Genetic Testing | Dosage | Recurrence Rate Per Group Recurrence/No Remission (%) | Comments |
|---|---|---|---|---|---|---|---|---|
| Plasmapheresis | Ohta et al. 2001 (75) | Children | Retrospective PPP versus none |
21 | No info | 2–3 sessions PP pre-transplant | PPP: 5 out of 15 (33%) None: 4 out of 6 (67%) |
No information on exclusion of genetic FSGS Multiple allografts per patient |
| Gohh et al. 2005 (76) | Adults + 1 child | Retrospective Single group (PPP) |
10 | No info | 8 sessions PP peri-Tx | PPP: 3 out of 10 (30%) | No control group Large differences in time point PP was started |
|
| Hickson et al. 2009 (77) | Adults + children | Retrospective PPP versus none |
30 | Not performed Familial FSGS excluded |
1 or more sessions PP pre-Tx | PPP: 6 out of 7 (86%) None: 7 out of 23 (30%) |
Study was designed to define patients with high-risk for FSGS recurrence, not to assess effects of PPP | |
| Gonzalez et al. 2011 (78) | Children | Retrospective PPP versus none |
34 | NPHS2 tested in 10 patients | 1–10 sessions PP pre-Tx | PPP: 9 out of 17 (53%) None: 10/17 (59%) |
1 patient had a heterozygous NPHS2 mutation | |
| Verghese et al. 2018 (79) | Children | Retrospective PPP versus none (historical cohort) |
51 | NPHS2 tested in PPP group | 1–3 sessions PP pre-Tx, 5 sessions post-Tx | PPP: 7 out of 26 (27%) None: 8 out of 31 (26%) |
Historical control group, significant differences between groups No genetic testing in control group |
|
| Plasmapheresis + rituximab | Alasfar et al. 2018 (80) | Adults | Prospective PPP+PRTX and PRTX versus none |
66 | Genetic FSGS excluded, no info on number of patients tested | 3–10 sessions PP peri-Tx 1–2 doses RTX |
PRTX and PPP+PRTX: 23 out of 37 (62%) None: 14 out of 27 (52%) |
Prophylactic treatment on the basis of high/low risk No differentiation between PRTX only and combined PRTX+PPP |
| Rituximab | Fornoni et al. 2011 (23) | Children | Retrospective PRTX versus none (historical cohort) |
41 | No info | 1 dose RTX (375 mg/m2) | PRTX: 8 out of 27 (30%)a None: 10 out of 14 (71%) |
Study was designed to investigate mechanisms of rituximab, therefore limited clinical data and significant differences between groups |
| LDL-apheresis + rituximab | Sannomiya et al. 2018 (81) | Adults | Retrospective Single group (RTX + LDL-apheresis) |
5 | No info | 1 dose RTX (100 mg) and 2 sessions LPL-apheresis pre-Tx | PRTX+LDL: 0 out of 5 (0%) | No control group Exclusion of secondary FSGS not mentioned |
PPP, prophylactic plasmapheresis; PP, plasmapheresis; Tx, transplant; PRTX, prophylactic rituximab.
a
No clear definition of FSGS recurrence; numbers are on the basis of treatment with plasmapheresis within 1 month after transplant.