Is Kidney Transplant Helpful for Patients with FSGS

FSGS is a kind of immune kidney disease. Patients can not do anything about it until dialysis or kidney transplant, but is dialysis or kidney transplant really help for patients with FSGS?

Unfortunately, many patients diagnosed with FSGS will eventually progress to kidney failure. Kidney transplant is a treatment option for these patients.
For some general information about kidney transplant.
The risk of FSGS returning in the transplanted kidney varies from 20-50%. There are several risk factors that put patients at higher risk of recurrence of FSGS. They are:

young age (< 15 years old)
if it took you less than 3 years from the time the FSGS was found in your original kidneys to reach kidney failure the appearance of certain cells on your original kidney biopsy (your nephrologist would have that information). Caucasian (White) race, if you lost a previous kidney transplant to a return of FSGS
Usually a return of FSGS in the transplant occurs very soon after the surgery. The FSGS can return within hours to days. Most episodes will be within the first year after transplant.

Is there any treatment for FSGS that comes back in a transplant?
The way that FSGS causes damage to the transplanted kidney is not entirely clear. There is some evidence that it may be due to a substance present in the blood. For this reason, some episodes of recurrent FSGS are treated with a procedure called Plasmapheresis. This procedure takes blood out of the body in small volumes. The damaging substance from the blood are removed. The rest of the blood is then returned to the patient. This therapy is most effective if started very soon after abnormal protein is detected in the urine.

In addition to Plasmapheresis, use of immunosuppressive medications (different than those used to prevent rejection of the kidney) is sometimes effective. Additionally, the use of medications to control blood pressure and reduce the protein in the urine is helpful.

Unfortunately, none of these treatments are very successful at treating FSGS that returns in the transplant.

If the FSGS does come back, will it cause me to lose my kidney transplant?

Over half of the patients with recurrent FSGS in their transplant will lose their kidney within 5 years. Of all the patients with FSGS who get a kidney transplant, about 15% will lose the kidney due to recurrent FSGS.