Table 1 Clinical characteristics and outcomes
At Tx | Case 1 | Case 2 | Case 3 |
Age at Tx | 23 | 24 | 36 |
Cause of ESRD | Unknown | Unknown | Unknown |
Duration of dialysis, mos | 16 | 9 | 10 |
HLA allele mismatches | 4/8 | 3/8 | 4/8 |
Blood type (Recipient & Donor) | O RhD + | A RhD + | O RhD + |
Donor age at Tx | 48 | 44 | 58 |
Donor type | LKT | LKT | LKT |
CDC test | Negative | Negative | Negative |
PRA pre-Tx | |||
Class I | Positive (NDSA) | Negative | Negative |
Class II | Positive (NDSA) | Negative | Negative |
Induction therapy | ATG | CTX | ATG |
Immunosuppressive therapy | TAC + MMF + PED | TAC + MMF + PED | CsA + MMF + PED |
Adverse events after Tx | Acute rejection | No | No |
SCr at discharge (μmol/L) | 228 | 95 | 110 |
At diagnosis | Case 1 | Case 2 | Case 3 |
Time to onset post-Tx, days | 45 | 60 | 39 |
Time to diagnosis post-Tx, days | 64 | 64 | 68 |
Proteinuria | ± | 2 + | 3 + |
Scr (μmol/L) | 840 | 300 | 605 |
LDH (U/L) | 742 | 463 | 612 |
HB (g/L) | 81 | 67 | 94 |
PLT (× 109/L) | 84 | 121 | 300 |
PRA | Negative | Negative | Positive (NDSA) |
Serum C3 (g/L) | NA | 0.90 | 0.48 |
Schistocytes on a PBS | < 2% | NA | < 2% |
Serum anti-GBM antibody | Negative | Negative | Negative |
Serum ANCA | Negative | Negative | Negative |
TAC blood concentration (ng/ml) | 7.7 | 9.9 | 7.2 |
Immunosuppressive therapy | TAC + MMF + PED | TAC + MMF + PED | CsA + MMF + PED |
Concomitant events | ABMR? CMV infection | CNI toxicity | ABMR |
Genetic testing (Recipient & Donor) | Variant c.721C > T in CFHR3 gene | Variant c.3572C > T in CFH gene | Variant c.3578C > G in CFH gene |
Treatment and prognosis | Case 1 | Case 2 | Case 3 |
Treatment therapy after diagnosis (time) | Ganciclovir PE (POD70, 72, 76) CRRT(POD78, 83, 86) | Convert TAC to SRL | PE Bortezomib (POD73, 78) Rituximab (POD75) |
Graft survival from time of Tx, days | 66 | 84 | 54 |
Outcome | Dialysis | Dialysis | Dialysis |