Journal Article

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 and S. R. Smith

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 11, issue 9, pages 1810-1814
Published in print September 1996 | ISSN: 0931-0509
e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/oxfordjournals.ndt.a027673
Renal transplantation in adults with thrombotic thrombocytopenic purpura/haemolytic-uraemic syndrome

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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%.

Journal Article.  0 words. 

Subjects: Nephrology

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