Thirty-Six Consecutive Kidney Transplants in Recipients with Atypical Hemolytic Uremic Syndrome: A Single-Centre Experience
1Kidney Transplantation, Fondazione IRCCS Ca&apos
Granda, Milan, Italy
2Centre for HUS Prevention, Control and Management, Fondazione IRCCS Ca&apos
Granda, Milan, Italy
3Nephrology, Fondazione IRCCS Ca&apos
Granda, Milan, Italy
4Pediatric Nephrology, Fondazione IRCCS Ca&apos
Granda, Milan, Italy.
Meeting: 2018 American Transplant Congress
Abstract number: 109
Keywords: Graft survival, Kidney transplantation, Outcome, Recurrence
Session Information
Session Name: Concurrent Session: Kidney Complications: Disease Recurrence
Session Type: Concurrent Session
Date: Sunday, June 3, 2018
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: Room Hall 4B
Background. Due to high recurrence rate, poor kidney transplant (KTx) survival has been reported for recipients with atypical hemolytic uremic syndrome (aHUS). More recently, prophylaxis with eculizumab has shown encouraging results. Methods. In this single-centre study with a median follow up of 42 months, we reviewed data from 36 KTx in patients with aHUS. KTx receiving prophylaxis with eculizumab (Eculizumab, 12 KTx in 12 recipients) were compared to those receiving no prophylaxis or prophylaxis with plasma-exchange (No-Eculizumab, 24 KTx in 22 recipients). Results. Baseline characteristics of the 2 groups were not statistically different but patients in No-Eculizumab had significantly longer follow up than Eculizumab (p<0.05). Main results (updated at last visit) are described in the table.
| Eculizumab
(12 KTx, 12 pts) Median (IQS) or % |
No-Eculizumab
(24 KTx, 22 pts) Median (IQS) or % |
P | |
| Patient survival (%) | 100 | 100 | ns |
| Graft survival (%) | 92 | 71 | ns |
| aHUS recurrence (%) | 0 | 46 | <0.05 |
| Rejection (%) | 25 | 29 | ns |
| DGF (%) | 8 | 17 | ns |
| Intraop. bleeding (%) | 17 | 37 | ns |
| Hospital stay (days) | 15 (11-24) | 20 (13-26) | ns |
| Severe infections (%) | 25 | 15 | ns |
| Serum creatinine (mg/dL) | 1.1 (0.9-1.2) | 1.8 (1.2-3.6) | 0.0536 |
| LDH (UI/L) | 175 (153-211) | 341 (246-412) | <0.05 |
| Haptoglobin (mg/dL) | 110 (70-136) | 105 (64-127) | ns |
| Platelet count (cellx1000/mcL) | 245 (204-309) | 192 (158-264) | ns |
| Follow up (months) | 26.5 (18-34) | 79 (6-117) | <0.05 |
Conclusions. For patients with aHUS, recurrence represents the main cause of KTx loss. Eculizumab significantly reduces the risk of recurrence and improves early graft survival. Aggressive peri-operative infection control strategies are advised to minimize infectious complications.
CITATION INFORMATION: Favi E., Ardissino G., Cresseri D., Brocca J., Testa S., Tel F., Giussani A., Colico C., Beretta C., Ferraresso M. Thirty-Six Consecutive Kidney Transplants in Recipients with Atypical Hemolytic Uremic Syndrome: A Single-Centre Experience Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Favi E, Ardissino G, Cresseri D, Brocca J, Testa S, Tel F, Giussani A, Colico C, Beretta C, Ferraresso M. Thirty-Six Consecutive Kidney Transplants in Recipients with Atypical Hemolytic Uremic Syndrome: A Single-Centre Experience [abstract]. https://atcmeetingabstracts.com/abstract/thirty-six-consecutive-kidney-transplants-in-recipients-with-atypical-hemolytic-uremic-syndrome-a-single-centre-experience/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress