Pre-emptive Eculizumab and Plasmapheresis for Renal Transplant in Atypical Hemolytic Uremic Syndrome
Pre-emptive Eculizumab and Plasmapheresis for Renal Transplant in Atypical Hemolytic Uremic Syndrome
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DOI：
10.2215/cjn.10181110
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发表时间：
2011-06-01
影响因子：
9.8
通讯作者：
Brophy, Patrick
中科院分区：
文献类型：
--
作者：
Nester, Carla;Stewart, Zoe;Brophy, Patrick
本文报告一例12岁儿童CFH/CFHL 1基因杂合型和非典型溶血性尿毒综合征（阿胡斯），该患者既往发生自体肾移植，然后发生肾移植物丢失。这个病例说明了阿胡斯晚期出现肾功能丧失的相对常见的情况。还提供了一种方案，用于预先使用依库珠单抗和血浆置换术作为肾移植计划的一部分，用于治疗被认为具有复发性疾病高风险的患者中的阿胡斯。该方案是多学科方法的结果，包括成人和儿童肾脏病学、移植手术、输血医学和传染病专家。该方案及其理由和组成部分可以作为一组儿童的治疗指南，这些儿童一直在等待美国第一次移植，为这种毁灭性疾病的最终护理打开大门。Clin J Am Soc Nephrol 6：1488-1494，2011. doi：10.2215/CJN.10181110
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. Clin J Am Soc Nephrol 6: 1488-1494, 2011. doi: 10.2215/CJN.10181110