CYCLOSPORINE THERAPY IN RECURRENT NEPHROT IC SYNDROME AFTER TRANSPLANTATION

From May 1992 to December 1994, 14 children with end stage renal failu re secondary to steroid-resistant idiopathic nephrotic syndrome receiv ed a cadaver kidney graft. Immediate recurrence of the nephrotic syndr ome occured in four patients. In the four patients, a complete remissi on was observed shortly after the start of intravenous cyclosporin; tw o children received in addition methylprednisolone pulses for secondar y rejection. Two children were still protein-free 9 and 15 months afte r transplantation. In the third patient, proteinuria relapsed after 9 months of complete remission and persisted in spite of the reintroduct ion of intravenous cyclosporin. The fourth graft was lost at 3,5 month from irreversible rejection. The creatinine clearance of the 3 functi oning grafts was respectively: 73, 76 and 92 ml/mn/1,73m(2) 16, 10 and 15 months after transplantation. Intravenous cyclosporin started shor tly after the reccurence, maintaining blood levels between 200 and 300 ng/ml, may induce a remission in recurrent nephrotic syndrome after r enal transplantation in childhood.