This case presentation will discuss the journey of a female patient from her initial admission to the paediatric renal unit at age ten, her transition to the adult transplant unit and return to

renal replacement therapy (RRT) under the care of the adult renal unit. Jane was JAK/stat pathway admitted to the paediatric renal unit with nephrotic syndrome associated with microscopic haematuria, proteinuria, hypertension and hypoalbuminaemia. A renal biopsy two weeks later revealed sclerosed glomeruli which confirmed the diagnosis of FSGS. Her renal function deteriorated over the next twelve months and despite second and third line therapies she commenced RRT. Twelve months later she received a renal transplant from her mother which check details was complicated by the recurrence of the disease within forty eight hours. She was treated with

plasmapheresis initially three times a week. Gradually the frequency was reduced according to her proteinuria. Plasmapheresis was finally ceased twelve months post transplant and she maintained good graft function.Jane managed to complete her secondary school education and achieved results that enabled her to commence her higher education in general nurse training. During her first year of training she was transitioned to the care of the adult transplant unit at nineteen years of age marking the next phase of her journey. She enjoyed another two years of good renal function before the recurrence of proteinuria. Plasmapheresis was commenced and frequency of treatment was managed according to her proteinuria. Jane completed her general nurse training and had secured a graduate nurse position when her renal function deteriorated further. Unfortunately, Jane had to face the next phase of her journey, to recommence RRT. Conclusion: The management of FSGS is extremely challenging. However, effective management

by the specialist medical and nursing staff, along with the support of the multidisciplinary team, allowed Jane to have treatment choices. Despite starting RRT, the team supported Jane on her choice of modality, increasing her independence and maintaining her social, family and Montelukast Sodium working life. It certainly was a rewarding experience caring for Jane on her journey from childhood to adulthood. ISHIZUKA KIYONOBU1, HARITA YUTAKA2, KAJIHO YUKO2, TSURUMI HARUKO2, ASANO TATSUO1, NISHIYAMA KEI1, SUGAWARA NORIKO1, CHIKAMOTO HIROKO1, AKIOKA YUKO1, YAMAGUCHI YUTAKA3, IGARASHI TAKASHI2, HATTORI MOTOSHI1 1Department of Pediatric Nephrology, Tokyo Women’s Medical University, School of Medicine, Tokyo, Japan; 2Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; 3Yamaguchi’s Pathology Laboratory, Matsudo, Chiba, Japan Introduction: The post-transplant recurrence of FSGS occurs about 30%, and impact on the graft survival.