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

Carla Nester; Zoe Stewart; David Myers; Jennifer Jetton; Ramesh Nair; Alan Reed; Christie Thomas; Richard Smith; Patrick Brophy

doi:10.2215/CJN.10181110

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

Journal article

Open access

Peer reviewed

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

Carla Nester, Zoe Stewart, David Myers, Jennifer Jetton, Ramesh Nair, Alan Reed, Christie Thomas, Richard Smith and Patrick Brophy

Clinical journal of the American Society of Nephrology, Vol.6(6), pp.1488-1494

06/2011

DOI: 10.2215/CJN.10181110

PMCID: PMC3109948

PMID: 21617085

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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.

Recurrence

Reoperation

Drug Administration Schedule

Humans

Mutant Chimeric Proteins - genetics

Patient Care Team

Graft Survival

Treatment Outcome

Kidney Transplantation

Preoperative Care

Plasmapheresis

Antibodies, Monoclonal, Humanized

Hemolytic-Uremic Syndrome - genetics

Time Factors

Antibodies, Monoclonal - administration & dosage

Female

Hemolytic-Uremic Syndrome - therapy

Atypical Hemolytic Uremic Syndrome

Child

Renal Dialysis

Details

Title: Subtitle: Pre-emptive eculizumab and plasmapheresis for renal transplant in atypical hemolytic uremic syndrome
Creators: Carla Nester - Department of Pediatrics, University of Iowa, Iowa City, Iowa 52242, USA. carla-nester@uiowa.edu
Zoe Stewart
David Myers - University of Iowa
Jennifer Jetton
Ramesh Nair
Alan Reed
Christie Thomas
Richard Smith
Patrick Brophy
Resource Type: Journal article
Publication Details: Clinical journal of the American Society of Nephrology, Vol.6(6), pp.1488-1494
DOI: 10.2215/CJN.10181110
PMID: 21617085
PMCID: PMC3109948
NLM abbreviation: Clin J Am Soc Nephrol
ISSN: 1555-905X
eISSN: 1555-905X
Publisher: United States
Grant note: K08 DK092284 / NIDDK NIH HHS K08 DK092284-02 / NIDDK NIH HHS K08 DK092284-01 / NIDDK NIH HHS
Language: English
Date published: 06/2011
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Accounting; Surgery; Obstetrics and Gynecology; Nephrology; Otolaryngology; Internal Medicine
Record Identifier: 9983985905302771

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