Renal transplantation in adults with thrombotic thrombocytopenic purpura/haemolytic-uraemic syndrome

P. J. Conlon, D. C. Brennan, W. W. Pfaf, W. F. Finn, T. Gehr, R. Randal Bollinger, S. R. Smith

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Thrombotic thrombocytopenic purpura/haemolytic-uraemic syndrome (TTP/HUS) is a rare cause of renal failure in adults. There is little data concerning the outcome of adult patients who receive a renal transplant for TTP/HUS. Methods. We have carried out a survey of 22 transplant centres in the USA to determine the outcome of patients who developed ESRD from TTP/HUS and latter received a renal transplant. Results. Twelve of the 22 centres responded to our inquiry. Seven centres had not transplanted any patients with TTP/HUS, and five centres had transplanted a total of 24 grafts in 17 patients with TTP/HUS. Thirty-three per cent of patients demonstrated definite clinical and pathological evidence of recurrence of TTP/HUS. An additional 16% of patients demonstrated pathological evidence of possible recurrence of TTP/HUS in the absence of clinical manifestations. The overall 1-year graft survival rate was 42% and the 2-year graft survival rate was 35%. In our experience recurrence TTP/HUS was associated with universal graft failure. Although cyclosporin A does occasionally cause a thrombotic angiopathy in patients with no history of TTP/HUS, we found no evidence that it should be avoided in patients with a previous history of ESRD from TTP/HUS who subsequently receive a renal transplant. Conclusions, TTP/HUS frequently recurres in adults who receive a renal transplant, with a 2-year graft survival rate of 35%.

Original languageEnglish (US)
Pages (from-to)1810-1814
Number of pages5
JournalNephrology Dialysis Transplantation
Volume11
Issue number9
DOIs
StatePublished - Sep 1996
Externally publishedYes

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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