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Pre-emptive eculizumab and plasmapheresis for renal transplant in atypical hemolytic uremic syndrome.

Authors
  • 1
  • 1 Department of Pediatrics, University of Iowa, Iowa City, Iowa 52242, USA. [email protected]
Type
Published Article
Journal
Clinical Journal of the American Society of Nephrology
1555-905X
Publisher
American Society of Nephrology
Publication Date
Volume
6
Issue
6
Pages
1488–1494
Identifiers
DOI: 10.2215/CJN.10181110
PMID: 21617085
Source
Medline
License
Unknown

Abstract

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.

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