Recurrence of hemolytic-uremic syndrome following live related renal transplantation

There is a significant risk of disease recurrence in patients with diarrhea-negative hemolyticuremic syndrome undergoing renal transplantation. Considering the low frequency of hemolyticuremic syndrome among adults with end-stage renal disease, only a few reports are available on the outcome of these patients after renal transplantation. It has been suggested, though not proven, that living related transplant recipients are at increased risk of recurrence of hemolyticuremic syndrome. We report a 23-year-old woman with end-stage renal disease, owing to postpartum hemolyticuremic syndrome and the recurrence of the disease following live related renal transplant. Investigators believe that some cases of atypical hemolytic-uremic syndrome are familial and related donors may have a genetic susceptibility to develop hemolytic-uremic syndrome. In addition, recurrence of hemolytic-uremic syndrome in the allograft is associated with a very poor prognosis. Therefore, at present, many clinicians are reluctant to recommend live related transplantation in any forms of diarrhea-negative hemolytic-uremic syndrome.