The hemolytic uremic syndrome (HUS) is a severe disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. We herein report our experience with a 43-year-old female patient who underwent a second cadaveric kidney transplantation in February 2005, for adult-onset HUS. The first renal transplantation, which was performed in 1996, required removal after 3 weeks for probable recurrence of HUS. The immunosuppressive regimen for the second transplant included basiliximab, tacrolimus, mycophenolate mofetil, and steroids. On postoperative day (POD) 7, she received steroid treatment for an acute rejection episode with improved renal function. On POD 19 due to worsening renal function, a graft biopsy showed HUS recurrence, thus we instituted hemodialysis and then plasmapheresis treatments. At two months after transplantation, the patient continued under plasmapheresis treatment due to clinical evidence of HUS. On POD 80, cytomegalovirus infection was diagnosed and intravenous gancyclovir treatment started for 3 weeks. After 110 days from transplant, a deterioration in renal function was evident: the graft was swollen and painful with Doppler ultrasound showing patency of both the renal artery and vein but, low blood flow. After 2 weeks of hemodialysis, the patient underwent transplantectomy. In adult-onset HUS the recurrence rate reduces graft survival, particularly among patients undergoing second transplantation.

Iaria, G., Iorio, B., Anselmo, A., De Luca, L., Tariciotti, L., Ielpo, B., et al. (2006). Graft failure due to hemolytic uremic syndrome recurrence. In Transplantation Proceedings (pp.1020-1021). NEW YORK : ELSEVIER SCIENCE INC [10.1016/j.transproceed.2006.02.019].

Graft failure due to hemolytic uremic syndrome recurrence

IORIO, BENIAMINO;DEL POETA, GIOVANNI;TISONE, GIUSEPPE
2006-05-01

Abstract

The hemolytic uremic syndrome (HUS) is a severe disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. We herein report our experience with a 43-year-old female patient who underwent a second cadaveric kidney transplantation in February 2005, for adult-onset HUS. The first renal transplantation, which was performed in 1996, required removal after 3 weeks for probable recurrence of HUS. The immunosuppressive regimen for the second transplant included basiliximab, tacrolimus, mycophenolate mofetil, and steroids. On postoperative day (POD) 7, she received steroid treatment for an acute rejection episode with improved renal function. On POD 19 due to worsening renal function, a graft biopsy showed HUS recurrence, thus we instituted hemodialysis and then plasmapheresis treatments. At two months after transplantation, the patient continued under plasmapheresis treatment due to clinical evidence of HUS. On POD 80, cytomegalovirus infection was diagnosed and intravenous gancyclovir treatment started for 3 weeks. After 110 days from transplant, a deterioration in renal function was evident: the graft was swollen and painful with Doppler ultrasound showing patency of both the renal artery and vein but, low blood flow. After 2 weeks of hemodialysis, the patient underwent transplantectomy. In adult-onset HUS the recurrence rate reduces graft survival, particularly among patients undergoing second transplantation.
29th Congress of the Italian-Society-of-Organ-Transplantation
Palermo, ITALY
NOV 03-05, 2005
29
Italian Soc Organ Transplantat
Rilevanza nazionale
contributo
nov-2005
mag-2006
Settore MED/18 - CHIRURGIA GENERALE
English
basiliximab; ganciclovir; mycophenolic acid 2 morpholinoethyl ester; steroid; tacrolimus; adult; anamnesis; article; biopsy; blood flow; cadaver kidney; case report; clinical feature; cytomegalovirus infection; Doppler flowmetry; female; graft survival; hemodialysis; hemolytic uremic syndrome; human; immunosuppressive treatment; kidney function; kidney graft rejection; kidney transplantation; kidney vein; plasmapheresis; postoperative period; priority journal; recurrent disease; renal artery; renal graft dysfunction; surgical technique; vascular patency; Adult; Female; Hemolytic-Uremic Syndrome; Humans; Kidney Transplantation; Plasmapheresis; Recurrence; Renal Dialysis; Reoperation; Treatment Failure; Treatment Outcome
Intervento a convegno
Iaria, G., Iorio, B., Anselmo, A., De Luca, L., Tariciotti, L., Ielpo, B., et al. (2006). Graft failure due to hemolytic uremic syndrome recurrence. In Transplantation Proceedings (pp.1020-1021). NEW YORK : ELSEVIER SCIENCE INC [10.1016/j.transproceed.2006.02.019].
Iaria, G; Iorio, B; Anselmo, A; De Luca, L; Tariciotti, L; Ielpo, B; Muzi, F; Lucchesi, C; D'Andria, D; Orlando, G; DEL POETA, G; Poggi, E; Piazza, A;...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/29097
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