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Post-transplantation outcome of patients with hemolytic-uremic syndrome: update

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Abstract

The outcome of renal transplantation in patients with hemolytic-uremic syndrome (HUS) is variable in reported cases. An update of the previously published series of patients from the University of Minnesota is reported. Seventeen patients with HUS received a renal transplant. Seven patients had recurrent HUS based on strict clinical and histological features and in 4 of these patients grafts were loss from recurrent HUS, with 1 patient losing three successive grafts. Three patients had histological features consistent with HUS but lacked some of the clinical features. Seven patients had no evidence of recurrent HUS post transplantation. The incidence of recurrence of HUS post transplantation in this updated report remains high (7/17 patients). There was no difference in the allografts used (living-related donor grafts were more common in all groups) or in the immunosuppression in the different groups of patients; only 1 patient with recurrent HUS received cyclosporine. The published cases of transplantation in patients with HUS show a variable recurrence rate of 0–25% in different centers with a poor graft outcome in patients with recurrence; a higher incidence of early chronic vascular rejection with decreased graft survival is also reported in patients without recurrence. Patients with HUS post renal transplant are at a variable risk of recurrence of HUS or decreased graft survival, and the factors responsible for this outcome are not known.

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Authors and Affiliations

  1. Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    Diane Hébert

  2. Department of Pediatrics, Soon Chun Hyang University Hospital, Seoul, Korea

    Eun-Mi Kim

  3. Department of Pathology, Stanford University Medical Center, Stanford, California, USA

    Richard K. Sibley

  4. Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA

    Michael S. Mauer

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  1. Diane Hébert
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  2. Eun-Mi Kim
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  3. Richard K. Sibley
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  4. Michael S. Mauer
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Hébert, D., Kim, EM., Sibley, R.K. et al. Post-transplantation outcome of patients with hemolytic-uremic syndrome: update. Pediatr Nephrol 5, 162–167 (1991). https://doi.org/10.1007/BF00852876

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  • DOI: https://doi.org/10.1007/BF00852876

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