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논문 기본 정보

자료유형
학술저널
저자정보
Min Eun-Ki (Department of Surgery Yonsei University College of Medicine Seoul KoreaResearch Institute for Transplantation Yonsei University College of Medicine Seoul Korea) Kim Hyun Jeong (Department of Surgery Yonsei University College of Medicine Seoul KoreaResearch Institute for Transplantation Yonsei University College of Medicine Seoul Korea) Kim Sinyoung (Department of Laboratory Medicine Yonsei University College of Medicine Seoul Korea) 정민선 (연세대학교) 김진석 (연세대학교 의과대학 세브란스병원 내과) 한승혁 (연세대학교) 허규하 (연세대학교)
저널정보
대한이식학회 Clinical Transplantation and Research Korean Journal of Transplantation Vol.37 No.1
발행연도
2023.3
수록면
57 - 62 (6page)
DOI
10.4285/kjt.22.0050

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Atypical hemolytic uremic syndrome (aHUS) is a form of thrombotic microangiopathy (TMA) that can result in end-stage renal disease. Patients with aHUS often have predisposing dysfunction in the complement pathway, and continuous activation of complement proteins can be triggered after transplantation. Here, we report the first successful case of aHUS treatment in a kidney transplant recipient with early use of a C5 inhibitor, eculizumab, in South Korea. The patient was a 32-year-old man, and the donor was his 60-year-old mother. The graft showed immediate good function. On postoperative day (POD) 3, the clinical diagnosis of TMA was made. Persistent renal dysfunction despite 10 plasma exchange (PE) sessions prompted eculizumab treatment on POD 18 under suspicion of aHUS. Next-generation sequencing reported gene mutations classified as variants of unknown significance in coagulation-associated genes. The patient was discharged after three doses of eculizumab with serum creatinine of 1.82 mg/dL. In total, 16 doses of eculizumab were administered. At the last follow-up, 21 months after eculizumab discontinuation, the graft was well functioning. De novo TMA after kidney transplantation can be caused by sustained activation of the complement pathway, and early eculizumab treatment appears important in the successful treatment of aHUS refractory to PE.

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