Abstract
Complement factor H (FH) deficiency is one of the causes of atypical hemolytic uremic syndrome (HUS). Most patients with FH deficiency associated HUS progress to end-stage renal disease despite plasma therapy. Moreover, the disease invariably recurs in the graft kidney and causes graft failure. We confirmed FH deficiency in a 30-month-old boy with recurrent HUS of 2 years duration, and attempted an auxiliary partial orthotopic liver transplantation (APOLT) to overcome the sustained intractable dependency on plasma therapy. APOLT restored the plasma FH level, without HUS recurrence, for 7 months. However, thereafter he suffered from serious infectious complications associated with immunosuppression and finally died 11 months after APOLT. In conclusion, although APOLT showed clinical and laboratory improvement for some period in this patient, the final fatal outcome suggests that liver transplantation should be cautiously applied to patients with HUS associated with FH deficiency.
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Acknowledgement
This study was supported by a grant from the Korea Health 21 R and D Project, Ministry of Health and Welfare, Republic of Korea (HMP-00-B-21000–0032) and the 2002 BK21 Project for Medicine, Dentistry and Pharmacy. Part of this work was presented at the ASN/ISN World Congress of Nephrology, 10–17 October 2001, San Francisco, Calif., USA [15].
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Cheong, H.I., Lee, B.S., Kang, HG. et al. Attempted treatment of factor H deficiency by liver transplantation. Pediatr Nephrol 19, 454–458 (2004). https://doi.org/10.1007/s00467-003-1371-2
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DOI: https://doi.org/10.1007/s00467-003-1371-2