Outcome of kidney transplants for adults with hemolytic uremic syndrome in the U.S. A ten-year database analysis

Alfonso H. Santos, Michael J. Casey, Xueron Wen, Ivan Zendejas, Chirag Faldu, Shehzad Rehman, Kenneth A. Andreoni

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: There is currently no large study of the U.S. transplant registry comparing the outcome of kidney transplantation for adults with and without hemolytic uremic syndrome (HUS). To date, information on the outcome of transplants for HUS in the U.S. is derived from single or combined-centers studies, but none has been of a nationwide scope. Material/Methods: We retrospectively studied a US registry for the outcome of 323 kidney transplants in adults with HUS and of 121 311 transplants in adults with other renal diseases during the period 1999-2009. We analyzed patient, over-all, and death-censored graft survival in the 5 years following transplantation using Kaplan-Meir curves and Cox hazard models. Results: In the 5 years following kidney transplantation, patient mortality was not significantly different [Hazard Ratio (HR) 1.27, 95% Confidence Interval (CI) 0.78-2.08], but death-censored graft loss was twice as common (HR 2.05, 95% CI 1.53-2.73) for allograft recipients whose native kidney disease was HUS compared to other transplant recipients. The subgroup (n=40 cases) with post-transplant HUS recurrence had a 5-year graft loss rate 5 times that of the subgroup (n=283 cases) without HUS-recurrence (graft survival 14.7% vs.77.4%, log rank 116.5; p<0.001). Conclusions: In the largest US series to date of kidney transplants for adults with HUS, 5-year patient survival was not different, but graft outcome was inferior in recipients whose native renal disease were HUS compared to recipients with other kidney diseases. Native kidney HUS is associated with a 2-fold increased risk of death-censored graft loss after kidney transplantation.

Original languageEnglish (US)
Pages (from-to)353-361
Number of pages9
JournalAnnals of Transplantation
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Hemolytic-Uremic Syndrome
Databases
Transplants
Kidney
Kidney Transplantation
Kidney Diseases
Graft Survival
Proportional Hazards Models
Registries
Confidence Intervals
Recurrence
Allografts
Transplantation

Keywords

  • Database
  • Hemolytic-uremic syndrome
  • Kidney transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Outcome of kidney transplants for adults with hemolytic uremic syndrome in the U.S. A ten-year database analysis. / Santos, Alfonso H.; Casey, Michael J.; Wen, Xueron; Zendejas, Ivan; Faldu, Chirag; Rehman, Shehzad; Andreoni, Kenneth A.

In: Annals of Transplantation, Vol. 19, No. 1, 01.01.2014, p. 353-361.

Research output: Contribution to journalArticle

Santos, Alfonso H. ; Casey, Michael J. ; Wen, Xueron ; Zendejas, Ivan ; Faldu, Chirag ; Rehman, Shehzad ; Andreoni, Kenneth A. / Outcome of kidney transplants for adults with hemolytic uremic syndrome in the U.S. A ten-year database analysis. In: Annals of Transplantation. 2014 ; Vol. 19, No. 1. pp. 353-361.
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abstract = "Background: There is currently no large study of the U.S. transplant registry comparing the outcome of kidney transplantation for adults with and without hemolytic uremic syndrome (HUS). To date, information on the outcome of transplants for HUS in the U.S. is derived from single or combined-centers studies, but none has been of a nationwide scope. Material/Methods: We retrospectively studied a US registry for the outcome of 323 kidney transplants in adults with HUS and of 121 311 transplants in adults with other renal diseases during the period 1999-2009. We analyzed patient, over-all, and death-censored graft survival in the 5 years following transplantation using Kaplan-Meir curves and Cox hazard models. Results: In the 5 years following kidney transplantation, patient mortality was not significantly different [Hazard Ratio (HR) 1.27, 95{\%} Confidence Interval (CI) 0.78-2.08], but death-censored graft loss was twice as common (HR 2.05, 95{\%} CI 1.53-2.73) for allograft recipients whose native kidney disease was HUS compared to other transplant recipients. The subgroup (n=40 cases) with post-transplant HUS recurrence had a 5-year graft loss rate 5 times that of the subgroup (n=283 cases) without HUS-recurrence (graft survival 14.7{\%} vs.77.4{\%}, log rank 116.5; p<0.001). Conclusions: In the largest US series to date of kidney transplants for adults with HUS, 5-year patient survival was not different, but graft outcome was inferior in recipients whose native renal disease were HUS compared to recipients with other kidney diseases. Native kidney HUS is associated with a 2-fold increased risk of death-censored graft loss after kidney transplantation.",
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AU - Santos, Alfonso H.

AU - Casey, Michael J.

AU - Wen, Xueron

AU - Zendejas, Ivan

AU - Faldu, Chirag

AU - Rehman, Shehzad

AU - Andreoni, Kenneth A.

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N2 - Background: There is currently no large study of the U.S. transplant registry comparing the outcome of kidney transplantation for adults with and without hemolytic uremic syndrome (HUS). To date, information on the outcome of transplants for HUS in the U.S. is derived from single or combined-centers studies, but none has been of a nationwide scope. Material/Methods: We retrospectively studied a US registry for the outcome of 323 kidney transplants in adults with HUS and of 121 311 transplants in adults with other renal diseases during the period 1999-2009. We analyzed patient, over-all, and death-censored graft survival in the 5 years following transplantation using Kaplan-Meir curves and Cox hazard models. Results: In the 5 years following kidney transplantation, patient mortality was not significantly different [Hazard Ratio (HR) 1.27, 95% Confidence Interval (CI) 0.78-2.08], but death-censored graft loss was twice as common (HR 2.05, 95% CI 1.53-2.73) for allograft recipients whose native kidney disease was HUS compared to other transplant recipients. The subgroup (n=40 cases) with post-transplant HUS recurrence had a 5-year graft loss rate 5 times that of the subgroup (n=283 cases) without HUS-recurrence (graft survival 14.7% vs.77.4%, log rank 116.5; p<0.001). Conclusions: In the largest US series to date of kidney transplants for adults with HUS, 5-year patient survival was not different, but graft outcome was inferior in recipients whose native renal disease were HUS compared to recipients with other kidney diseases. Native kidney HUS is associated with a 2-fold increased risk of death-censored graft loss after kidney transplantation.

AB - Background: There is currently no large study of the U.S. transplant registry comparing the outcome of kidney transplantation for adults with and without hemolytic uremic syndrome (HUS). To date, information on the outcome of transplants for HUS in the U.S. is derived from single or combined-centers studies, but none has been of a nationwide scope. Material/Methods: We retrospectively studied a US registry for the outcome of 323 kidney transplants in adults with HUS and of 121 311 transplants in adults with other renal diseases during the period 1999-2009. We analyzed patient, over-all, and death-censored graft survival in the 5 years following transplantation using Kaplan-Meir curves and Cox hazard models. Results: In the 5 years following kidney transplantation, patient mortality was not significantly different [Hazard Ratio (HR) 1.27, 95% Confidence Interval (CI) 0.78-2.08], but death-censored graft loss was twice as common (HR 2.05, 95% CI 1.53-2.73) for allograft recipients whose native kidney disease was HUS compared to other transplant recipients. The subgroup (n=40 cases) with post-transplant HUS recurrence had a 5-year graft loss rate 5 times that of the subgroup (n=283 cases) without HUS-recurrence (graft survival 14.7% vs.77.4%, log rank 116.5; p<0.001). Conclusions: In the largest US series to date of kidney transplants for adults with HUS, 5-year patient survival was not different, but graft outcome was inferior in recipients whose native renal disease were HUS compared to recipients with other kidney diseases. Native kidney HUS is associated with a 2-fold increased risk of death-censored graft loss after kidney transplantation.

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