PLASMA-EXCHANGE IN THE TREATMENT OF EARLY RECURRENT FOCAL GLOMERULOSCLEROSIS AFTER RENAL-TRANSPLANTATION - REPORT AND REVIEW

We report a 29-year-old female with recurrent focal glomerulosclerosis (FGS) presenting as heavy proteinuria immediately following renal tra nsplantation. From day 13 after transplantation, daily plasma exchange was performed 6 times. Proteinuria decreased from 13 to 0.2 g/day aft er plasma exchange and remained to be less than 0.1 g/day even 20 mont hs thereafter. Our review of the literature on the use of plasma excha nge in treating recurrent FGS suggests this procedure is not useful in patients whose allograft biopsy showed advanced glomerular sclerotic lesions. We propose early plasma exchange may be a therapeutic option in those patients who have no sclerotic lesions in their allograft bio psy.