A 66 year old female with a past medical history of end stage
renal disease presumed secondary to diabetic nephropathy (no kidney biopsy
performed), who underwent hemodialysis for 3 years, presented
for cadaveric renal transplant. Her major medical co-morbidities included
essential hypertension, mild coronary artery disease, prior bleeding gastric
ulcer, hypothyroidism, and obesity.
Her past surgical history was remarkable for failed
arteriovenous fistula, appendectomy, and tonsillectomy. Her prior known
sensitizing events included a prior pregnancy, one miscarriage, remote blood
transfusion, but no previous transplants.
Her relevant family history included diabetes, hypertension,
with no known family history of HUS or thrombotic thrombocytopenic purpura
(TTP). Her relevant laboratory values pretransplant were serum hemoglobin of
12.9, CMV antibody negative, blood type B+, and calculated panel reactive antibody
(PRA) of 55%.
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