RECURRENCE OF HEMOLYTIC-UREMIC SYNDROME IN RENAL-TRANSPLANT RECIPIENTS - A METAANALYSIS

Background. Recurrence of hemolytic-uremic syndrome (HUS) in the allog raft is associated with a very poor renal prognosis. Meta-analysis of previous trials may allow us to better estimate its real frequency, to identify risk factors for recurrence, and to predict the outcome of p atients with definite recurrence. Methods. An exhaustive search was co nducted of HUS recurrence in renal transplantation from January 1977 t o June 1997 using MEDLINE, Results. Ten studies comprising 159 grafts in 127 patients were identified. The rate of recurrence was 27.8%. One -year graft survival was 76.6% in patients without recurrence and 33.3 % in patients with recurrence (P<0.001). Older age at onset of HUS (16 .96+/-7.6 years vs. 9.95+/-6.55 years; P<0.02), shorter mean interval between HUS and transplantation (2.51+/-2.7 years vs, 6.03+/-6.4 years ; P<0.01), shorter mean interval between HUS and end-stage renal disea se (0.79+/-0.39 years vs. 2.78+/-2.47 years; P<0.01), living-related d onors, and the use of calcineurin inhibitors were associated with recu rrence. Conclusion. Risk factors for HUS recurrence in renal transplan tation could be identified through this metaanalysis.