Background. Focal segmental glomerulosclerosis (FSGS) often develops rapidly and frequently progresses to renal failure, while\nthe recurrence rate after kidney transplantation is 20ââ?¬â??50%. We performed low-density lipoprotein (LDL) apheresis before kidney\ntransplantation in FSGS patients to prevent recurrence. Methods. Five adult patients with chronic renal failure due to FSGS\nundergoing living related donor kidney transplantation were investigated retrospectively. LDL apheresis was done 1-2 times before\ntransplantation. Postoperative renal function and recurrence of FSGS were assessed. Results. The patientswere two men and three\nwomen aged 24 to 41 years. The observation period ranged from 60 days to 22 months. Preoperative LDL apheresis was performed\nonce in one patient and twice in four patients. Blood LDL cholesterol levelswere normal before LDL apheresis and remained normal\nboth after LDL apheresis and after kidney transplantation. Additional LDL apheresis was performed once in one patient with mild\nproteinuria after transplantation.The renal graft survived in all patients and there was no evidence of recurrent FSGS. Conclusions.\nAlthough the observation period was short, FSGS did not recur in all 5 patients receiving preoperative LDL apheresis. These results\nsuggest that LDL apheresis can be effective in preventing recurrence of FSGS after kidney transplantation.
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