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Correspondence to Author: Natas gopal,V.Polimera,Jessica,Erik Wash,Elizabeth Feder. 

Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033, USA.

Abstract: The rare but potentially lethal thrombotic microangiopathy (TMA) known as complement-mediated hemolytic uremic syndrome (CM-HUS), formerly known as atypical HUS, is typified by the triad of acute kidney injury, microangiopathic hemolytic anemia(MAHA), and thrombocytopenia. The main cause of it is complement dysregulation. End-stage renal disease (ESRD), which frequently calls for a kidney transplant, can develop from the illness. Rarely, persons who have had a kidney transplant may acquire it.
Methods: Two patients with thrombocytopenia, anemia, and acute renal damage who had ESRD status after kidney transplantation are described here. The work-up in both cases suggested CM-HUS, and eculizumab was used to stabilize the condition.
Disscussion: Complement inhibitors like eculizumab can be used for both initial care and relapse prevention because the pathophysiology of CM-HUS involves deregulation of the complement system. After eculizumab treatment, the relapse rate might be anywhere between 20 and 67%. Compared to people with native kidneys, patients with a history of kidney transplantation are more likely to relapse. Relapses can be well managed with complement inhibitor retreatment, and long-term use of complement inhibitor drugs is advised to avoid recurrence.
Conclusions:CM-HUS is uncommon and potentially lethal, particularly in post-transplant patients. Clinicians must identify and treat this problem as soon as possible. Complement inhibitors are frequently used in management. Patients with a history of kidney transplantation are especially at risk for relapse, but long-term use of these drugs can help avoid relapse.

Citation:

Natas gopal. A Lifeline For Patients With Complement-Mediated Hemolytic Uremic Syndrome Following Renal Transplantation: Ongoing Anticomplement Therapy. Journal of Advanced Therapeutics 2025.