MO195ATYPICAL HEMOLYTIC UREMIC SYNDROME IN LUNG TRANSPLANTATION: TREATMENT WITH ECULIZUMAB, OUR EXPERIENCE

Abstract Background and Aims Atypical haemolytic uremic syndrome (aHUS) is a clinical entity characterized by acute kidney injury, thrombocytopenia microangiopathic hemolytic anemia. There are several cases of AHUS in non-renal solid organ transplants described the literature, included lung transplant. Kidney patient survival compromised this complication because lack an effective treatment. Eculizumab C5 complement factor specific blocker already administered another kind secondary aHUS with encouraging results Method We analys six retrospective single-center study between 2018-2020 who developed were treated eculizumab. Clinical analytical data collected along follow-up. Principal outcome was to explore haematologycal renal response after treatment Results total patients (83% female) median age 57 years at time transplantation. Aetiologies transplantation chronic obstructive pulmonary disease 2 patients, interstitial 2, cystic fibrosis remaining two. Induction maintenance immunosuppressive therapy based on tacrolimus, mycophenolate prednisone all cases. Baseline serum creatinine 1.1 mg/dl (0.9-2.4). Two immediate post-transplant, one them died surgical complications. Another four 59 months (33-95) Previously thrombotic microangiopathy, three everolimus instead two have cytomegalovirus reactivation. At onset, 4mg/dl (2.4-5-7) dialysis performed 50% patients. Median hemoglobin 7.2g/dl (6.9-7.7), platelet count 32x1000/µL (17-58), DHL 1343 U/L (581-1597) start eculizumab despite having trigger. After 6 doses eculizumab, five surviving had response. No underwent dialysis. Serum 2.2 (1.7-2.3), 9.8 g/dl 159x1000/µL end Conclusion critical transplantation, shortly related therapy. Patients risk stage disease. appears promising.