Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

21 May 2009

Hemolytic uremic syndrome (HUS)/thrombotic microangiopathy (TMA) in renal allograft recipients-prognostic factors

O Kozińska-Przybył, A Mróz, Z Lewandowski, A Chmura, Z Gałązka, M Durlik

Ann Transplant 2009; 14(1): 26-26 :: ID: 880292


Material/Methods: 74 cases of TMA were identified from the histopathology database of Department of Transplantation Medicine and Nephrology in  Warsaw (Poland). Archived renal biopsy specimen and accompanying medical records for each patient were obtained and reviewed. Patients were divided into 2 groups: A (n=32) who developed HUS until 1 month post-transplant and B (n=42) who developed TMA later. Data extracted from each clinical record included: HLA histocompatibility, CIT,treatment of HUS/TMA, infections, type of immunosuppressant drugs. Data extracted from biopsy specimen included: presence of C4D deposits, PTC infl ammatory infiltrates, necrosis of vascular wall, presence of clotting, tubulitis, chronic vascular, glomerular and interstitial changes and interstitial inflammatory infiltrates. Cox Model was used and HR was estimated. End point was time of returning on haemodialysis.
Results: Patients from group A became dialysis dependent later compared to group B (observation time 108 months, HR=0.33; p<0.001). After 70 months of
observation 73% of patients from group B returned on dialysis and 33 % of
group  A. Risk factors of returning on dialysis despite the time of developing HUS/TMA were: presence of clotting (HR=3.076; p<0.01), necrosis of vascular wall (HR 3.921; p<0.0359), tubulitis (HR 2,.373; p<0.0492), PTC inflammatory infiltrates (HR 5.467; p<0.0273). No correlation with C4D deposits was found.
Conclusions: Negative prognostic factors might be connected with coexistence of acute interstitial and/or vascular rejection in a renal biopsy specimen. It can be assumed that histopathology findings usually considered associated with acute rejection should prompt additional clinical management. On the other hand C4D deposits seem not to be sufficient to unequivocally diagnose acute rejection as factor C4D did not differentiate our patients. Further investigation is mandatory.

Keywords: Kidney Transplantation

Add Comment 0 Comments

In Press

06 Feb 2024 : Case report  

Successful Sequential Liver and Isolated Intestine Transplantation for Mitochondrial Neurogastrointestinal ...

Ann Transplant In Press; DOI: 10.12659/AOT.941881  

12 Feb 2024 : Original article  

No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Li...

Ann Transplant In Press; DOI: 10.12659/AOT.942767  

21 Feb 2024 : Original article  

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians

Ann Transplant In Press; DOI: 10.12659/AOT.943498  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358