Recurrence of hemolytic-uremic syndrome in renal transplant recipients: a meta-analysis

Transplantation. 1998 May 27;65(10):1405-7. doi: 10.1097/00007890-199805270-00023.


Background: Recurrence of hemolytic-uremic syndrome (HUS) in the allograft 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 patients with definite recurrence.

Methods: An exhaustive search was conducted of HUS recurrence in renal transplantation from January 1977 to 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 disease (0.79+/-0.39 years vs. 2.78+/-2.47 years; P<0.01), living-related donors, and the use of calcineurin inhibitors were associated with recurrence.

Conclusion: Risk factors for HUS recurrence in renal transplantation could be identified through this meta-analysis.

Publication types

  • Meta-Analysis

MeSH terms

  • Age Distribution
  • Calcineurin Inhibitors
  • Graft Survival / physiology
  • Hemolytic-Uremic Syndrome / complications
  • Hemolytic-Uremic Syndrome / drug therapy
  • Hemolytic-Uremic Syndrome / epidemiology
  • Hemolytic-Uremic Syndrome / surgery*
  • Humans
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation*
  • Recurrence
  • Risk Factors
  • Time Factors


  • Calcineurin Inhibitors