A Successful Renal Transplant in a Pediatric Patient With Glanzmann Thrombasthenia and Hyperimmunization

Exp Clin Transplant. 2019 Dec;17(6):831-834. doi: 10.6002/ect.2019.0174. Epub 2019 Oct 1.

Abstract

We report the case of a patient with type 2 Glanzmann thrombasthenia who underwent successful kidney transplant with his mother's kidney. He started dialysis at 13 months. The patient had been diagnosed with Glanzmann thrombasthenia at 9 years old, after hemorrhagic shock, during which multiple transfusions were required and hyperimmunization had developed. At 12 years old, he received a kidney transplant. Before transplant, ABO- and HLA-compatible platelet donors were identified and convened to donate forthe surgery and in case of emergency. Bleeding was prevented withprophylacticHLA-matched platelet transfusion and tranexamic acid. After transplant, diuresis started immediately with excellent graft function and no severe bleeding. However, after week 5, several episodes of macroscopic hematuria occurred, with obstruction and anuria. The double J ureteric stent was replaced 4 times in 2 months. Finally, the ureteric stent was removed 9 months later. At 22 months after kidney transplant, the patient has a normal graft function and no further bleeding has occurred, underlying the importance of multidisciplinary management.

Publication types

  • Case Reports

MeSH terms

  • ABO Blood-Group System
  • Antifibrinolytic Agents / administration & dosage
  • Child
  • Female
  • HLA Antigens / blood
  • HLA Antigens / immunology*
  • Histocompatibility*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / immunology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Living Donors
  • Male
  • Mothers
  • Platelet Transfusion
  • Thrombasthenia / blood
  • Thrombasthenia / diagnosis
  • Thrombasthenia / immunology*
  • Thrombasthenia / therapy
  • Time Factors
  • Treatment Outcome

Substances

  • ABO Blood-Group System
  • Antifibrinolytic Agents
  • HLA Antigens
  • Immunosuppressive Agents