Pre-emptive Eculizumab and Plasmapheresis for Renal Transplant in Atypical Hemolytic Uremic Syndrome
Open Access
- 1 June 2011
- journal article
- case report
- Published by Wolters Kluwer Health in Clinical Journal of the American Society of Nephrology
- Vol. 6 (6), 1488-1494
- https://doi.org/10.2215/cjn.10181110
Abstract
Summary The case of a 12-year-old with a hybrid CFH/CFHL1 gene and atypical hemolytic uremic syndrome (aHUS) that had previously developed native kidney and then renal allograft loss is reported. This case illustrates the relatively common occurrence of renal loss from the late presentation of aHUS. Also presented is a protocol for the pre-emptive use of eculizumab and plasmapheresis as part of a renal transplant plan for the treatment of aHUS in patients deemed at high risk for recurrent disease. This protocol was a result of a multidisciplinary approach including adult and pediatric nephrology, transplant surgery, transfusion medicine, and infectious disease specialists. This protocol and the justifications and components of it can function as a guideline for the treatment of a group of children that have waited in limbo for the first U.S. transplant to open the door to this type of definitive care for this devastating disease.Keywords
This publication has 37 references indexed in Scilit:
- Relative Role of Genetic Complement Abnormalities in Sporadic and Familial aHUS and Their Impact on Clinical PhenotypeClinical Journal of the American Society of Nephrology, 2010
- aHUS caused by complement dysregulation: new therapies on the horizonPediatric Nephrology, 2010
- Genetics and complement in atypical HUSPediatric Nephrology, 2010
- Prophylactic Eculizumab after Renal Transplantation in Atypical Hemolytic–Uremic SyndromeNew England Journal of Medicine, 2010
- Maintenance of Kidney Function Following Treatment With Eculizumab and Discontinuation of Plasma Exchange After a Third Kidney Transplant for Atypical Hemolytic Uremic Syndrome Associated With a CFH MutationAmerican Journal of Kidney Diseases, 2010
- Efficacy of Eculizumab in the Treatment of Recurrent Atypical Hemolytic-Uremic Syndrome After Renal TransplantationTransplantation, 2010
- Mutations in alternative pathway complement proteins in American patients with atypical hemolytic uremic syndromeHuman Mutation, 2010
- Association of factor H autoantibodies with deletions of CFHR1, CFHR3, CFHR4, and with mutations in CFH, CFI, CD46, and C3 in patients with atypical hemolytic uremic syndromeBlood, 2010
- Successful Renal Transplantation in Factor H Autoantibody Associated HUS with CFHR1 and 3 Deficiency and CFH Variant G2850TAmerican Journal of Transplantation, 2010
- Combined kidney and liver transplantation for familial haemolytic uraemic syndromeThe Lancet, 2002