Date: Monday, June 3, 2019
Session Name: Poster Session C: Kidney: Acute Cellular Rejection
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: The ratio of early renal allograft loss caused by hyperacute rejection, severe surgical complications and sever infection decreased gradually during recent years. Atypical hemolytic uremic syndrome(aHUS)leading to early graft loss in renal allograft was rare in previous studies, aHUS was related to the gene variations of complement regulatory proteins. This study want to report aHUS in renal allograft with complement regulatory proteins gene variations
*Methods: The data from four kidney transplantation centers in China from Jan 2014 to Jun 2018 was collected in this study. The receipts with renal allograft loss less than three months were collected. They received both renal allograft biopsy and the test of genes encoding for complement regulatory proteins using a GenCap custom enrichment kit (MyGenostics).
*Results: Total 2580 receipts received renal transplantation in four centers,15 receipts had renal allograft loss less than three months. Four receipts (two living donors and two DCD donors, primary kidney diseases were unknown) were diagnosed with aHUS based on clinical and histological changes (thrombotic microangiopathy). One case was diagnosed with acute antibody-mediated rejection and one was diagnosed with acute cellular rejection in previous biopsies. They were treated the plasma exchange (4 cases), IVIG (2 cases), rituximab(2case) and bortezomib (1 case). Four patients have CFH gene variations (Patient 1 c.3578C>G (p.T1193R) in exon22, Patient 2: c.3572C>T (p.S1191L) in exon 22, c.3172T>C (p.S1191L) and c.3178G>C (p.V1060L) in exon20. Patient 3: c.3566T>C in exon 22 , Patient 4 c.3172T>C (p.Y1058H) and c.3178G>C (p.V1060L) in exon 20). Among the causes of early allograft loss, aHUS was the first cause in living-donor transplant receipts and the third cause in all transplant receipts (living donor and DCD).
*Conclusions: Although aHUS in renal allograft was uncommon,it was one of main causes leading to early renal allograft loss during these years. The complement factor H gene variations might be susceptibility gene for this severe complication. The pre-operation evaluation should add the test of genes encoding for complement regulatory proteins to evaluate the potential risk for this disease.
To cite this abstract in AMA style:Wen J, Jin Z, Gong N, Xu X. Atypical Hemolytic Uremic Syndrome Concomitant Complement Factor H Gene Variations Leading to Early Renal Allograft Loss: Multicenter Cases Report from China [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/atypical-hemolytic-uremic-syndrome-concomitant-complement-factor-h-gene-variations-leading-to-early-renal-allograft-loss-multicenter-cases-report-from-china/. Accessed August 12, 2020.
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