Rituximab or plasmapheresis for prevention of recurrent focal segmental glomerulosclerosis after kidney transplantation: A systematic review and meta-analysis

Table 3 Detailed characteristics of included studies evaluating the outcomes of preemptive plasmapheresis

Ref.	Country	Age	Genetic testing	Race	Time to ESKD	Repeat KT	Induction	IS	Donor types	Biopsy	Follow-up duration
Kawaguchi et al[20], 1994	Japan	2-12 yr at FSGS Dx	N/A	Asian	12–117 mo		ATG only in PP group	CS, CsA, AZA/mizolibine	13/14 living1/14 DDKT	N/A	N/A
Otsubo et al[21], 1999	Japan	22 yr at KT	N/A	Asian	N/A	N/A	CS, CsA/Tac	CS, CsA/Tac, AZA/mizolibine	34/37 LRKT, 4/37 DDKT	Per-cause biopsy	N/A
Iguchi et al[32], 1997	Japan	33.3 (20-43) yr	N/A	Asian	N/A	None	ATG during first 2 wk in PP group	CS, CsA, AZA	100% LRKT	Intra-op biopsy (1 h) in all cases then as clinically indicated	N/A
Ohta et al[33], 2001	Japan	Age of FSGS onset69.5 ± 36.4 mo (range 9-134 mo)	N/A	Asian	51.8 ± 29.6 mo (range 7-120)	1/21	None	CS, CsA/Tac, AZA/mizolibine	3/21 DDKT (14%) vs 18/21 (LRKT)	Intra-op biopsy (1 h) in all cases then as clinically indicated	62.7 (PP group), 41.6 mo (non-PP group)
Somers and Baum[34], 2009	Unite States	12.5 yr (85% white)	N/A	85% White	3 yr (median)	N/A	N/A	CsA-based regimen	42% living donor	N/A	N/A
Gonzalez et al[35], 2011	United States	Age at KT: 13 ± 5 yr	NPHS2 mutation testing on 10 patients (9 tested negative, 1 with heterozygous mutation)	29% White, 15% African, 44% Hispanic, 12% others	4.2 yr (n = 19, recurrence group), 3.1 yr (n = 15, no recurrence group)	Recurrence in previous graft 5/34	rATG (if ATN) or daclizumab	CS, CsA/Tac, MMF	15/34 living, 19/34 DDKT	Per-cause biopsy	N/A
Miyauchi et al[25], 2011	Japan	N/A	N/A	Asian	N/A	N/A	N/A	CS, CsA/Tac, AZA/mizolibine	N/A	N/A	N/A
Park et al[26], 2014	South Korea	Age at KT: 39 ± 14 yr (n = 7, recurrence), 36 ± 11 yr (n = 20, no recurrence)	N/A	Asian	46 ± 44 mo (n = 7, recur group), 68 ± 67 mo (n = 20, no recur group)	none	Basiliximab (20 mg) on days 0 and 4	CS, CsA/Tac, MMF	4/27 DDKT, 24/27 living (17/27 LRKT)	Per-cause biopsy	N/A
Okumi et al[27], 2015	Japan	N/A	N/A	Asian	N/A	N/A	Basiliximab (after 2002)	CS, CsA/Tac, MMF	N/A	N/A	N/A
Verghese et al[36], 2018	United States	Age at KT: 13.2 ± 4.5 yr (after 2006 with PP) vs 10.4 ± 5.4 yr (before 2006, no PP)	NPHS2 mutation testing (for those with NPHS2 homozygous mutation, PP not indicated)	N/A	N/A	N/A	93% received lymphocyte depleting induction	Before 2006: AZA (90%), MMF (16%), CsA (97%), CS (97%). After 2006: AZA (12%), MMF (88%), CsA (62%)/Tac (38%), CS (12%)	DDKT 37% vs Living 63%	Per-cause biopsy	N/A
Koyun et al[37], 2019	Turkey	Age at KT: 7.2 ± 1.2 yr (PP) vs 10.7 ± 4.5 yr (no PP)	Genetic testing (unspecified gene panel): 2/6 + in PP group vs 14/40+ in control group	N/A	N/A	N/A	N/A	N/A	DDKT 20%, Living 80%	N/A	N/A
Campise et al[38], 2019	Italy	Age at FSGS Dx: 27 (15-35) yr. Age at KT: 41 (38-52) yr	Not done	100% White	5 (1-10) yr, 33% rapid (< 3 yr) progression to ESKD	(7/21) 33% in PP group; previous graft loss due to recurrence	Basiliximab (20 mg) on days 0 and 4	CS, Tac, MMF	100% DDKT	Per-cause biopsy	45 (30-107) mo
Uffing et al[8], 2020	Unites States, Europe, Brazil	Age at KT: 38 (29–47) yr. Age at FSGS Dx: 27 (17-40) yr	Not done in most patients	56% White, 11% Black, 5% Hispanic, 5% Asian, 10% mixed, Other or unknown 14%	38 (14–75) mo	25%; prior graft loss due to FSGS 9%	rATG (42%), basiliximab (42%), daclizumab (3%), none (13%)	CS + Tac + MMF (72%), CS + CsA + MMF (17%), Tac + MMF (5%), other 6%	67% DDKT, 22% LRKT, 15% LUKT	Per-cause biopsy	N/A

N: Number; ESKD: End-stage kidney disease; FSGS: Focal segmental glomerulosclerosis; PP: Plasmapheresis; KT: Kidney transplantation; RTX: Rituximab; N/A: Not available; LUKT: Living-related kidney transplantation; CS: Corticosteroids; CsA: Cyclosporine; Tac: Tacrolimus; MMF: Mycophenolate mofetil; AZA: Azathioprine; rATG: Rabbit anti-thymocyte globulin; DDKT: Deceased donor kidney transplantation; LRKT: Living-related kidney transplantation.