Possible hemolytic uremic syndrome in three cats after renal transplantation and cyclosporine therapy

Objective-To describe the clinical history of 3 cats with possible hemolyti c uremic syndrome (HUS) after renal transplantation. Study Design-This case series documents historical findings, physical exami nation findings, clinical pathologic features, necropsy and histopathologic findings of 3 cats with possible HUS. Results-Two cats had chronic renal failure; 1 cat had acute renal failure s econdary to ethylene glycol toxicity. A renal transplant was performed in e ach of the 3 cats without obvious problems. Complications that would suppor t a diagnosis of HUS, including anemia, thrombocytopenia, and azotemia occu rred within 24 hours in 1 cat, within 8 days in a second cat, and 2 months after transplantation in the third cat. In 2 cars, HUS was likely secondary to cyclosporine immunosuppression. Tn the third cat, HUS may have been sec ondary to allograft rejection. Renal biopsies from all 3 cats were suggesti ve of HUS. Conclusion and Clinical Relevance-In human beings, HUS in transplant recipi ents may occur secondary to immunosuppressive drugs, vascular rejection, or recurrence of original disease. Graft loss occurred in all 3 cats in this study and the mortality rate was 100%. Clinicians caring for these patients need to be aware of this disorder because early recognition and treatment is critical in the management of post-transplant HUS. (C) Copyright 1999 by The American College of Veterinary Surgeons.