Renal Transplantation and Immunological Abnormalities in Thrombotic Microangiopathy of Adults

Arias-Rodríguez, Manuel; Sraër, Jean-Daniel; Kourilsky, O; Smith, Mary D.; Verroust, P; Meyrier, Alain; Kuntziger, Henri-Edouard; Kanfer, A; Nessim, Victoria; Neuilly, Ghislaine; Morel-Marogér, L; Richet, G

doi:10.1097/00007890-197704000-00010

Cited by 11 publications

(4 citation statements)

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“…The heterogeneity of outcome is not surprising, given the heterogeneity of the syndrome itself. Possible factors favouring recurrence are early placement of grafts in acute disease, since it was rare in patients who remained on dialysis for several months before grafting [64], whereas we lost four cadaver grafts in two adult patients transplanted within 3 months of onset, with a pattern consistent with recurrent disease. However Hebert et al [61] report immediate recurrence after 3-5 years on dialysis in two children.…”

Section: Haemolytic-uraemic Syndromesmentioning

confidence: 97%

“…Eijenraam et al [63], in probably the largest single centre experience reported, found probable recurrence of HUS in only 2 first grafts out of 24 placed into 20 children. In adults, recurrence seems to be rare [64], and the Australian-New Zealand data showed only 5 graft losses in 36 cases [6]. Thus overall about 10% of recipients may be expected to show recurrence, in the majority of whom the graft will be lost.…”

Section: Haemolytic-uraemic Syndromesmentioning

confidence: 99%

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Recurrent primary disease and de novo nephritis following renal transplantation

1991

Pediatr Nephrol

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Recurrent or de novo diseases account for only 5% of graft failure in children, but have much to teach us about mechanisms. In children, almost the only metabolic disease with recurrence is type I hyperoxaluria, in which the poor long-term results of isolated renal transplantation make combined liver and renal transplantation, or even prophylactic liver transplantation before renal failure the preferable alternatives. While many forms of nephritis may show histological recurrence in allografts, it is notable that in many patients this is accompanied by no clinical manifestations or only mild disease: this is particularly so in mesangiocapillary glomerulonephritis (MCGN) type II. IgA-associated nephropathy and Henoch-Schönlein purpura. However focal segmental glomerulosclerosis and MCGN type I recur with sufficient frequency and severity to deter the use of living donors unless there is no alternative. The same is true of haemolytic-uraemic syndromes. As many as 10% of paediatric grafts may show de novo membranous nephropathy, but in the majority this is mild or not clinically evident. In contrast, the rare anti-glomerular basement membrane nephritis affecting some patients with Alport's syndrome usually results in graft failure, but occurs in only a minority of recipients with the syndrome. For all types of disease in allografts, risk factors for recurrence are poorly worked out, and attempts at treatment generally ineffective.

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Section: Haemolytic-uraemic Syndromesmentioning

confidence: 97%

Section: Haemolytic-uraemic Syndromesmentioning

confidence: 99%

Recurrent primary disease and de novo nephritis following renal transplantation

1991

Pediatr Nephrol

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“…However, Kaplan [1] has observed more than one relapse in 30 patients with HUS. Successful renal transplantation has been reported both in children and adults with the HUS [11][12][13][14][15]. Recurrences of HUS, eitherwith spontaneous recovery]!, 2,10, 16,17] or graft failure [3,5,6], have also been observed in renal transplant patients.…”

Section: Discussionmentioning

confidence: 99%

Apparent Recurrence of Hemolytic Uremic Syndrome in Azathioprine-Treated Allograft Recipients

Griñó¹,

Caralps²,

Carreras³

et al. 1988

Nephron

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The present study describes 3 adult patients with hemolytic uremic syndrome (HUS) leading to chronic renal failure. Following renal transplantation, the 3 patients developed microangiopathic hemolytic anemia associated with acute rejection crises and graft failure. In 2 patients the renal histology of the transplanted kidney was consistent with HUS. It is concluded that, in adult patients, HUS may recur after renal transplantation and contribute to renal graft failure.

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“…A meta-analysis of the results of 10 observational studies published between 1977-1997 has been reported (Table 39) (332)(333)(334)(335)(336)(337)(338)(339)(340)(341). In the meta-analysis there were 159 grafts in 127 patients with ESRD from hemolytic uremic syndrome (HUS), although data on risk factors were available for only about half of these patients (342).…”

Section: The Evaluation Of Renal Transplant Candidates: Clinical Pracmentioning

confidence: 99%

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

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Renal Transplantation and Immunological Abnormalities in Thrombotic Microangiopathy of Adults

Cited by 11 publications

References 0 publications

Recurrent primary disease and de novo nephritis following renal transplantation

Recurrent primary disease and de novo nephritis following renal transplantation

Apparent Recurrence of Hemolytic Uremic Syndrome in Azathioprine-Treated Allograft Recipients

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

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