An ABO incompatible renal transplant from a living donor for atypical hemolytic uremic syndrome resulted in graft loss because of hyperacute humoral rejection

Abstract

A 22-year-old man with chronic renal failure caused by atypical hemolytic uremic syndrome (HUS) underwent an ABO incompatible renal transplant from his living father following preoperative double filtration plasmapheresis twice and one plasma exchange (PE). Function of the transplanted kidney was good immediately after the surgery, but urinary output on the 1st postoperative day decreased and the patient received PE and hemodialysis. Despite careful control of circulation and coagulation, renal function was lost on the 3rd postoperative day and the grafted kidney was removed. Histological features of the removed allograft indicated blood vessel type rejection and not recurrence of HUS.