Four consecutive renal transplantations in a patient with adenine phosphoribosyltransferase deficiency.
Clin Nephrol
; 61(3): 217-21, 2004 Mar.
Article
de En
| MEDLINE
| ID: mdl-15077874
ABSTRACT
We report a patient with complete adenine phosphoribosyltransferase deficiency and urolithiasis, in whom 4 consecutive cadaveric renal transplantations were performed; 2,8-dihydroxyadenine crystal nephropathy recurred within weeks in the first and second graft when the patient was not treated with allopurinol immediately after transplantation. In the third graft, recurrence of disease could be prevented by immediate allopurinol treatment. This graft was lost due to chronic allograft nephropathy without significant crystal deposition. After a fourth transplantation, again without initial allopurinol, the disease recurred following an initial vascular rejection. Addition of allopurinol significantly improved renal function of the 2nd and 4th graft. This case indicates that outcome of renal transplantation in patients with adenine phosphoribosyltransferase deficiency critically depends on immediate postoperative pharmacotherapy with allopurinol, which is able to prevent 2,8-dihydroxyadenine nephropathy in the graft. Furthermore, rapid recurrence of disease without allopurinol seems to be triggered by delayed graft function and acute rejection.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Adenine phosphoribosyltransferase
/
Calculs urinaires
/
Transplantation rénale
Limites:
Adult
/
Humans
/
Male
Langue:
En
Journal:
Clin Nephrol
Année:
2004
Type de document:
Article
Pays d'affiliation:
Autriche