Graft loss from a living donor due to flash recurrence of focal segmental glomerular sclerosis — case report

Focal segmental glomerular sclerosis is a pattern of histological damage of the kidney. The most common clinical manifestation is proteinuria, however, it can frequently progress to full nephrotic syndrome. Glucocorticosteroids are the first line of treatment and, in case of resistance, calcineurin inhibitors are used. In some patients, despite treatment, focal segmental glomerular sclerosis leads to end-stage renal disease, in which organ transplantation is the only therapeutic option. In several cases, relapse occurs in the transplanted organ. The following paper presents a case report of a patient treated for focal segmental glomerular sclerosis since the age of 21, who developed end-stage renal failure after seven years of disease despite immunosuppressive treatment. Although there was a significant risk of recurrence, it was decided to transplant a kidney from a family donor — the patient’s mother. From about one week after transplantation, progressive deterioration of graft function was observed.