Recurrence of nephrotic syndrome/focal segmental glomerulosclerosis following renal transplantation in children

center dot The incidence of recurrence of nephrotic syndrome/focal segmental glomerulosclerosis (NS/FSGS) is variable (similar to 30%) center dot The incidence of recurrence is less in African-Americans than in whites and Hispanics center dot Graft survival rates are decreased in recipients with FSGS, especially if remission of the NS is not achieved in those with recurrence center dot Although controversial, the use of living donor (LD) transplants are not contraindicated; however, obligatory heterozygote parental grafts with a podocin mutation should be used with caution center dot Optimal treatment to induce a remission post-transplant has not been delineated center dot Pre-transplant and/or prophylactic post-transplant pre-operative plasmapheresis (PP) for high-risk patients-especially those with recurrence in a previous graft-may be promising center dot An international multicenter controlled study is required to delineate the optimal approach to prevent and/or treat the recurrence of NS/FSGS.