Mycophenolate mofetil and prednisone as maintenance treatment after kidney transplantation

Background. Hemolytic uremic syndrome (HUS) is an infrequent but severe complication of kidney transplantation. Cyclosporine-induced microangiopathy may be the causative factor in allograft recipients with HUS. In transplant recipients with HUS, discontinuation of cyclosporine is generally advised. This often leads to loss of the graft. Methods. An adult kidney transplant recipient developed HUS in the third week after transplantation. Maintenance immunosuppression was changed to mycophenolate mofetil and prednisone after cyclosporine was discontinued. Results. The change in immunosuppressive therapy led to remission of the HUS and stable graft function. Conclusions. In transplant recipients receiving cyclosporine who suffer from HUS, the possibility of conversion from cyclosporine to mycophenolate mofetil should be considered. As this case shows, complete remission of HUS and maintenance of the graft are possible.