Purpose: Our study aimed to determine the difference in patient and graft outcomes between HUS Kidney Transplant Recipients (HUSKTR) with and without disease recurrence after KT.

Method: We retrospectively analyzed SRTR transplant data over a 10 year period. Adult HUSKTR were categorized into disease recurrence (DR) and no disease recurrence (NDR) groups. DR is based on composite of discrete data categories in the SRTR database .Patient and Graft Survival were compared between the 2 groups.

Results: Based on the SRTR database, we analyzed 122,435 kidney transplant recipients (KTR) from January 1, 1999 to December 31, 2009 with ages between 18 and 74 years and received dialysis treatment for 0 to 30 years. 323 (0.3%) had renal failure from HUS. After KT, 12.4% had DR and 87.6% had NDR. Out of 18 donor, recipient, and transplant characteristics only acute rejection rates and recipient Black race were significantly different between the two groups. Analysis showed that patient survival was not different between HUS KTR with DR and NDR (P=0.7678).

The 5 year graft failure rates between patients with and without HUS recurrence were compared. During the period studied, the graft survival was significantly lower for the HUS-DR group than the HUS-NDR group (49.0 vs. 89.2 % at 1 yr.; 14.7 % vs. 66.8 % at 5 yr.). The difference is significant in multivariate cox analysis. (HR: 7.9 ,P < 0.0001). Dialysis length was not significant (HR=0.98, P=0.6446).

Conclusion: For the 10-year period analyzed, there was no difference in KT patient survival between HUS DR and HUS NDR. However, graft survival was inferior in the HUS recurrence compared to the non-recurrence group.

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