Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction: KTX in aHUS patients is associated with a high rate of relapse and graft loss. Here, we report on seven aHUS cases with end-stage renal disease that were treated with peritransplant plasma exchange (PE)/infusion (PI) and ECU rescue in case of relapse/treatment intolerance.
Methods: Peritransplant PE (40ml/kg bodyweight) was carried out from days 0 to 3, then thrice weekly until stabilization of graft function followed by weekly PI (20ml/kg bodyweight). In case of intolerance/failure, ECU was started.
Results: Seven aHUS patients (mean age at first aHUS episode: 23±9 years; mean age at 1st KTX 26±9 years) enrolled in the Vienna TMA cohort received a mean of 10±4 PE. PI was not administered in two patients (case 1, 7). Graft function remains excellent in five of our patients. Case 3 was discontinued PI after 7 years without any consequence. Four patients were switched to ECU because of (i) relapse triggered by a 3rd pregnancy (case 4), (ii) early relapse 12 months after KTX (case 5; died 34 months later of an unknown cause), (iii) intolerance to PI (case 6) and (iv) a severe aHUS relapse triggered by antibody mediated rejection two weeks after KTX (case 7; plasma intolerance at 2nd PE).
|Case||Sex||Age at last KTX|
|No. of KTX||Mutation||PE|
(mg/dL; last available)
Conclusion: Preemptive PE/PI is effective for prevention of aHUS relapse in patients without disease activity at the time of KTX. Five patients considered as genetically high-risk candidates showed no early recurrence of disease.
CITATION INFORMATION: Aigner C., Böhmig G., Eskandary F., Gaggl M., Kain R., Sunder-Plassmann R., Prohaszka Z., Schmidt A., Sunder-Plassmann G. Preemptive Plasma Therapy and Eculizumab (ECU) Rescue for Atypical Hemolytic Uremic Syndrome (aHUS) Relapse Following Kidney Transplantation (KTX) Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Aigner C, Böhmig G, Eskandary F, Gaggl M, Kain R, Sunder-Plassmann R, Prohaszka Z, Schmidt A, Sunder-Plassmann G. Preemptive Plasma Therapy and Eculizumab (ECU) Rescue for Atypical Hemolytic Uremic Syndrome (aHUS) Relapse Following Kidney Transplantation (KTX) [abstract]. https://atcmeetingabstracts.com/abstract/preemptive-plasma-therapy-and-eculizumab-ecu-rescue-for-atypical-hemolytic-uremic-syndrome-ahus-relapse-following-kidney-transplantation-ktx/. Accessed November 22, 2019.
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