Successful living-related renal transplantation in a patient with factor H antibody-associated atypical hemolytic uremic syndrome

Pediatr Transplant. 2015 Aug;19(5):E121-5. doi: 10.1111/petr.12519. Epub 2015 Jun 3.

Abstract

CFH-Ab-associated aHUS requires different diagnostic and therapeutic approaches and then the genetically defined aHUS forms. The risk of post-transplant recurrence with graft dysfunction in CFH-Ab aHUS is not well documented. It is suggested that recurrence can be expected if a significant CFH-Ab load persists at the time of transplantation. A pretransplant procedure to reduce CFH-Ab titer seems reasonable, but accurate recommendations are lacking. Whether further prophylactic interventions after transplantation are necessary has to be decided on an individual basis. We report the case of a late diagnosed CFH-Ab HUS with initial ESRD and a successful living-related renal transplantation over a post-transplant period of four and a half years on the basis of a prophylactic pretransplant IVIG admission.

Keywords: atypical HUS; complement factor H antibodies; intravenous immunoglobulins; plasma therapy; renal transplantation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies / immunology*
  • Atypical Hemolytic Uremic Syndrome / complications*
  • Atypical Hemolytic Uremic Syndrome / surgery*
  • Child
  • Complement Factor H / immunology*
  • Graft Survival
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / chemistry
  • Kidney Transplantation / methods*
  • Living Donors
  • Male
  • Recurrence
  • Renal Insufficiency / complications
  • Renal Insufficiency / surgery*
  • Treatment Outcome

Substances

  • Antibodies
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Complement Factor H