Successful Reuse of Kidney Graft After Early Recurrence of Primary Focal and Segmental Glomerulosclerosis

Parietal epithelial cells maintain the epithelial cell continuum forming Bowman's space in focal segmental glomerulosclerosis

“…In general, the described process may be important to keep the glomeruli functional, and one may speculate that, in case of remission or successful treatment, the glomeruli remain (partly) functional, without further progression of FSGS. A recent case study by Hamroun et al (2021) may support this theory. In this particular study, a kidney with recurrence of primary FSGS was retransplanted 8 months after transplantation and reimplanted in another patient.…”

“…In the 4- and 12-month biopsies after reimplantation, the kidney still showed FSGS lesions in over two-thirds of the glomeruli. However, foot-process effacement was reduced and kidney function was restored, indicating that the lesions were inactive and did not affect kidney function ( Hamroun et al, 2021 ).…”

The Deceased Transplant Recipients: A Forgotten Source of Organ Donors

“…The small number of case reports scattered during the last three decades [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] did not catch the attention of the transplant community until analyses were published from the organ transplant agencies on both sides of the Atlantic [33][34][35]. Lowell et al, with data of the United Network for Organ Sharing and The Scientific Transplant Registry, reported findings on forty-eight recipients of previously re-used kidneys transplanted between October 1987 and June 1996 and compared them to those of 68,568 patients receiving native organs during the same period [33].…”

“…This large gap of unused good kidneys may be explained by the presence of surgical damage occurring during the unusual explanation procedure and the low acceptance of the novel re-used kidney. Karakizlis et al [32], with the Euro-transplant data between January 1995 and December 2015, identified 9 DWGF kidneys amongst 68,554 recipients. Four of these were transplanted successfully, with grafts surviving between 3 and 18 years.…”

“…The re-use of a transplant kidney affected by early recurrent focal segmental glomerulosclerosis in a living donor was first reported in 2012, by Gallon et al from Chicago, to simultaneously cure the disease in the donor and give a new life to the new host recipient [24]. The unusual procedure was replicated successfully in two other patients [25,32]. These events strongly suggest that FSGS is a disease of the host, and retransplanting this kidney affected by FSGS into another recipient devoid of the circulating factor would obviate the problem.…”