@article{16a3b04d33ec44a6b96c3a8014f34b34,
title = "Clinical practice recommendations for recurrence of focal and segmental glomerulosclerosis/steroid-resistant nephrotic syndrome",
abstract = "Recurrence of primary disease is one of the major risks for allograft loss after pediatric RTx. The risk of recurrence of FSGS/SRNS after pediatric RTx in particular can be up to 86% in idiopathic cases. There is a need for consensus recommendations on its prevention and treatment. The CERTAIN study group has therefore performed a thorough literature search based on the PICO model of clinical questions to formulate educated statements to guide the clinician in the process of decision-making. A set of educated statements on prevention and treatment of FSGS/SRNS after pediatric RTx has been generated after careful evaluation of available evidence and thorough panel discussion. We do not recommend routine nephrectomy prior to transplantation; neither do we recommend abstaining from living donation. Special attendance needs to be given to those patients who had already experienced graft loss due to FSGS/SRNS recurrence. Early PE or IA with or without high-dose CsA and/or rituximab seems to be most promising to induce remission. The educated statements presented here acknowledge that FSGS/SRNS recurrence after pediatric RTx remains a major concern and is associated with shorter graft survival or even graft loss. The value of any recommendation needs to take into account that evidence is based on cohorts that differ in ethnicity, pre-transplant history, immunosuppressive regimen, definition of recurrence (eg, clinical and/or histological diagnosis) and treatment modalities of recurrence.",
keywords = "children, focal-segmental glomerulosclerosis, recurrence, renal transplantation, steroid-resistant nephrotic syndrome",
author = "Weber, {Lutz T.} and Burkhard T{\"o}nshoff and Ryszard Grenda and Antonia Bouts and Rezan Topaloglu and Bora G{\"u}lhan and Nikoleta Printza and Atif Awan and Nina Battelino and Rasmus Ehren and Hoyer, {Peter F.} and Gregor Novljan and Marks, {Stephen D.} and Jun Oh and Agnieszka Prytula and Tomas Seeman and Clodagh Sweeney and {Dello Strologo}, Luca and Lars Pape",
note = "Funding Information: Lutz T Weber has received research funding from Chiesi GmbH, honoraria from Alexion, and travel grants from Astellas Pharma GmbH. Burkhard T{\"o}nshoff Dr T{\"o}nshoff has received travel grants from Astellas and Novartis; grant/research support from Astellas, Lilly, Novartis, Novo Nordisk, and Roche; and has acted as a consultant to Bristol‐Myers Squibb, Chiesi, and Novartis. Antonia Bouts is member of an independent data monitoring committee for a clinical study sponsored by GlaxoSmithKline (EudraCT No 2019‐000607‐33). Jun Oh has received travel grants from Astellas Pharma GmbH, Alexion, Alnylam, Recordati, and Chiesi GmbH and research funding from Chiesi GmbH. Nikoleta Printza has received a research grant from Baxter. Lars Pape received travel grants from Astellas Pharma GmbH, ALexion, and Chiesi GmbH as well as research grants from Chiesi GmbH. Ryszard Grenda, Rezan Topaloglu, Bora G{\"u}lhan, Atif Awan, Rasmus Ehren, Gregor Novljan, Stephen Marks, Agnieszka Prytula, Tomas Seeman, Clodagh Sweeney, and Luca dello Strologo have nothing to disclose. Funding Information: This work received financial support by the European Society for Paediatric Nephrology (ESPN) (2.000 €) and the German Society for Paediatric Nephrology (GPN) (5.000 €) for creation of the evidence table. Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC",
year = "2021",
month = may,
doi = "https://doi.org/10.1111/petr.13955",
language = "English",
volume = "25",
pages = "e13955",
journal = "Pediatric transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "3",
}