Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Renal transplantation in patients with classical haemolytic-uraemic syndrome

Abstract

Eighteen records from children with renal transplants (RT) and classical haemolytic-uraemic syndrome (HUS) were reviewed. The mean oliguric period was 17.9±7.5 days; the interval between acute phase and endstage renal disease (ESRD) was 9.3±5.2 years. HUS was the most frequent cause of renal transplantation (23.4%). There were no significant differences between patients with HUS and controls (children with RT but without HUS), regarding renal function, frequency of rejections, renal survival (HUS 65%, controls 57%) or patient survival (94.4% and 96.6%, respectively) after 9 years. None had clinical or histopathological evidence of HUS recurrence in the allograft. Of all children with living-related donors (LRD), renal survival after 3 years was longer for those who received cyclosporin A (CSA) (HUS and controls 86%) than for those who did not receive it (HUS 50%, controls 53%). Classical HUS is a frequent cause of ESRD in Argentina. The duration of the acute oliguric period is a good predictor of the likelihood of progression to chronicity. In the classical form of HUS there is no recurrence in the allograft. CSA and LRD can be used without risk in renal transplantation of children with classical HUS.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Gianantonio CA (1977) Epidemiology and prevention of kidney disease (Southamerica) (abstract). Abstracts of the 4th meeting of the International Pediatric Nephrology Association, Helsinki, Finland. August 1–4

  2. 2.

    Gianantonio CA, Vitacco M, Mendilaharzu F, Gallo G (1968) The hemolytic uremic syndrome. Renal status of 76 patients at long term follow-up. J Pediatr 72:757–765

  3. 3.

    McCrory W (1968) A new cause for an old disease-chronic nephritis. J Pediatr 72:912–914

  4. 4.

    Gianantonio CA, Vitacco M, Mendilaharzu F, Gallo GE, Sojo ET (1973) The hemolytic uremic syndrome. Nephron 11:174–192

  5. 5.

    Gianantonio CA, Vitacco M, Mendilaharzu F (1966) The hemolyticuremic syndrome. Proceedings of the 3rd International Congress of Nephrology, Washington. Karger, Basel, pp 24–36

  6. 6.

    Hebert D, Sibley RK, Mauer SM (1986) Recurrence of hemolytic uremic syndrome in renal transplant recipient. Kidney Int 30: S51-S58

  7. 7.

    Remuzzi G (1987) Nephrology forum: HUS and TTP: variable expression of a single entity. Kidney Int 32:292–308

  8. 8.

    Strom TB, McCluskey RT (1986) Renal disorder 13 months after renal transplantation for the hemolytic uremic syndrome. N Engl J Med 314:1032–1040

  9. 9.

    Lerilli GS, Nelsen C, Dorfmann L (1972) Renal homotransplantation in infants and children with the hemolytic uremic syndrome. Surgry 71:66–71

  10. 10.

    Folman R, Arbus GS, Churchill B, Gaum L, Huber J (1978) Recurrence of the hemolytic uremic syndrome in a 3 1/2 year old child, 4 months after second renal transplantation. Clin Nephrol 10:121–127

  11. 11.

    Gianantonio CA (1984) Past and present of the hemolytic uremic syndrome in Argentina. In: Strauss J (ed). Acute renal disorders and renal emergencies. Nijhoff, Boston, pp 13–20

  12. 12.

    Gianantonio CA, Vitacco M, Mendilaharzu F, Rutty A, Mendilaharzu J (1964) The hemolytic uremic syndrome. J Pediatr 64: 478–491

  13. 13.

    De Christofano MA, Fayad A, Ferraris J, Cortinez C, Ramirez J, Ascione A, Gianantonio C (1986) Sindrome urémico hemolítico de la infancia. Su relación con la presencia de verotoxina libre fecal. Arch Argent Pediatr 84:339–342

  14. 14.

    Novillo AA, Voyer IE, Cravioto R, Freire MC, Castaño G, Wainstein R, Binztein N (1988) Hemolytic uremic syndrome associated with fecal cytotoxin and verotoxin neutralizing antibodies. Pediatr Nephrol 7:288–290

  15. 15.

    Broyer M (1984) Incidence and etiology of ESRD in chilren. In: Fine RN, Gruskin AB (eds) End stage renal disease in children. Saunders, Philadelphia, p 9

  16. 16.

    Bonser RS, Adv D, Franklin I, McMaster P (1984) Cyclosporin induced hemolytic uremic syndrome in liver allograft recipient (letter). Lancet II:1337

  17. 17.

    Vanrenterghem TL, Roels L, Lerut T, Grunez J, Michielsen P, Gresele P, Deckmyn H, Colucci M, Arnout J, Vermylen J (1985) Thromboembolic complications and hemostatic changes in cyclosporin treated cadaveric kidney allograft recipients. Lancet I:999–1002

  18. 18.

    Neild GH, Ivory K, Williams DG (1983) Glomerular thrombi and infarction in rabbits with serum sickness following cyclosporin therapy. Transplant Proc 15:2782–2786

  19. 19.

    Powles RL, Morgenstern GR, Kay HEM, Clink HEM, Dady PJ, Barret A, Jameson B, Depledge MH, Watson JG, Sloane J, Leigh M, Lumley H, Hedley D, Lawler SD, Filshie J, Robinson B (1983) Mismatched family donors for bone marrow transplantation as treatment for acute leukaemia. Lancet I:612–615

  20. 20.

    Leithner S, Sinzinger H, Pohanka E, Schwarz M, Kretschmer G, Syre G (1983) Occurrence of hemolytic uremic syndrome under cyclosporin treatment: accident or possible side effect mediated by a lack of prostacyclin-stimulating plasma factor. Transplant Proc 15: 2787–2789

  21. 21.

    Leithner S, Sinzinger H, Pohanka E, Schwarz M, Kretschner G, Syre G (1982) Recurrence of HUS triggered by cyclosporine after renal transplantation (letter). Lancet I:1470

  22. 22.

    Eijgenraam FJ, Donckerwolcke RA, Monnens LA, Proesmans W, Wolff ED, Damme B van (1990) Renal transplantation in 20 children with hemolytic-uremic syndrome. Clin Nephrol 33:87–93

  23. 23.

    Ashkenazi S, Cleary TG, Lopez E, Pickering LK (1988) Anticytotoxin-neutralizing antibodies in immune globulin preparations: potential use in hemolytic uremic syndrome. J Pediatr 113:1008–1014

Download references

Author information

Correspondence to Jorge Ferraris.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bassani, C.E., Ferraris, J., Gianantonio, C.A. et al. Renal transplantation in patients with classical haemolytic-uraemic syndrome. Pediatr Nephrol 5, 607–611 (1991). https://doi.org/10.1007/BF00856651

Download citation

Key words

  • Haemolytic-uraemic syndrome
  • Renal transplant
  • Recurrence in the allograft
  • Post-transplant evolution