儿童肾移植后溶血尿毒综合征的复发：北美儿科肾移植协作研究报告
Recurrence of hemolytic uremic syndrome after renal transplantation in children: a report of the North American Pediatric Renal Transplant Cooperative Study.
作者信息
Quan A, Sullivan E K, Alexander S R
机构信息
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063, USA.
出版信息
Transplantation. 2001 Aug 27;72(4):742-5. doi: 10.1097/00007890-200108270-00033.
BACKGROUND
Hemolytic uremic syndrome (HUS) is the cause of renal failure in 2-4% of children on dialysis. After renal transplantation, HUS can recur, but recurrence rate and risk factors are controversial.
METHODS
We reviewed the recurrence of HUS within the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) registry and used a separate questionnaire to ascertain additional clinical information.
RESULTS
Of 68 renal allografts, HUS recurred in 6 allografts (8.8%) occurring in five patients (8.2%). Four patients had atypical HUS, whereas one patient had classic HUS. HUS recurred after transplantation in 33 days or less in all but one allograft. Outcome was poor with five of six allografts lost, despite treatment with fresh-frozen plasma or plasmapheresis. Cyclosporine had no effect on outcome or HUS recurrence.
CONCLUSIONS
The risk of HUS recurrence in the allograft is 8-9% and is heightened in atypical HUS. Treatment was not effective and graft outcome was poor. Cyclosporine does not affect HUS recurrence.
背景
溶血性尿毒症综合征（HUS）是2% - 4%接受透析治疗儿童肾衰竭的病因。肾移植后，HUS可能复发，但复发率和危险因素存在争议。
方法
我们回顾了北美儿科肾移植协作研究（NAPRTCS）登记处HUS的复发情况，并使用单独的问卷来确定额外的临床信息。
结果
在68例肾移植受者中，6例移植肾（8.8%）出现HUS复发，涉及5名患者（8.2%）。4例患者为非典型HUS，1例患者为典型HUS。除1例移植肾外，其余移植肾均在移植后33天或更短时间内复发HUS。尽管采用新鲜冷冻血浆或血浆置换治疗，但6例移植肾中有5例丢失，预后较差。环孢素对预后或HUS复发无影响。
结论
移植肾中HUS复发风险为8% - 9%，非典型HUS复发风险更高。治疗无效，移植肾预后较差。环孢素不影响HUS复发。
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