Combined liver–kidney transplantation is a possible treatment for patients with atypical hemolytic uremic syndrome associated with factor H mutations

Translational Mini-Review Series on Complement Factor H: Therapies of renal diseases associated with complement factor H abnormalities: atypical haemolytic uraemic syndrome and membranoproliferative glomerulonephritis

“…The reasons for this may include increased susceptibility of the transplanted liver to ischaemic or immune injury related to uncontrolled complement activation. Additional combined kidney and liver transplants have been performed subsequently in three patients with CFH mutations [37,38], who received extensive plasma exchange pre‐ and post‐transplant, in order to remove mutant CFH and provide enough normal CFH to prevent liver graft damage. Of note in the latter two patients, heparin‐based anti‐coagulation was started a few hours after the combined transplantation to prevent thrombotic events [38].…”

“…Additional combined kidney and liver transplants have been performed subsequently in three patients with CFH mutations [37,38], who received extensive plasma exchange pre‐ and post‐transplant, in order to remove mutant CFH and provide enough normal CFH to prevent liver graft damage. Of note in the latter two patients, heparin‐based anti‐coagulation was started a few hours after the combined transplantation to prevent thrombotic events [38]. So far, all three patients who were treated with this regimen had a favourable post‐transplant outcome with well‐functioning grafts.…”