Table 2.
Pharmacotherapy of APRT deficiency and kidney allograft outcomes
| Patient | Treatment before Tx | Age at RRT (yrs) | Graft number | Age at Tx (yrs) | Type of donor | Pharmacotherapy | Outcome | Last follow-up (yrs after Tx) | Latest eGFR (mL/min/1.73 m2) |
|---|---|---|---|---|---|---|---|---|---|
| 1 | No | 62 | 1 | 65 | DD | Febuxostat 40 mg/day from 3 weeks post-Tx | Recurrence of DHA 3 weeks post-Tx; functioning graft | 1.6 | 25 |
| 2 | No | 38 | 1 | 39 | DD | None | Graft lost due to recurrence of DHA nephropathy 1 month post-Tx | 0.1 | ESKD |
| No | 39 | 2 | 42 | DD | Allopurinol 200 mg/day from 6 months post-Tx | Recurrence of DHA nephropathy 3 days post-Tx and allograft failure at 13 months post-Tx; died while on dialysis | 1.1 | ESKD | |
| 3 | No | 42 | 1 | 43 | DD | Allopurinol 300 mg/day from 4 months post-Tx | Died with a functioning graft | 0.5 | 41 |
| 4 | No | 65 | 1 | 67 | DD | Allopurinol 150 mg/day from 3 weeks post-Tx | Functioning graft | 6.5 | 28 |
| 5 | No | 45 | 1 | 46 | DD | Allopurinol 150 mg/day from 3 years post-Tx | Died with a functioning graft | 5.4 | 29 |
| 6 | No | 50 | 1 | 51 | DD | Allopurinol 300 mg/day from 5 weeks post-Tx, later febuxostat 80 mg/day | Recurrence of DHA nephropathy 24 days post-Tx; lost after 19 months | 1.7 | AKI/dialysis |
| 7 | No | 44 | 1 | 58 | LRD | Allopurinol 300 mg/day from 2 months post-Tx | Functioning graft | 9.7 | 37 |
| 8 | No | 12 | 1 | 15 | DD | None | Graft lost 18 months post-Tx | 1.5 | ESKD |
| No | 16 | 2 | 17 | DD | Allopurinol 300 mg/day from day 28 post-Tx | Recurrence of DHA nephropathy 1 month post-Tx, graft lost after 3.4 years | 3.4 | ESKD | |
| Yes | 20 | 3 | 21 | DD | Allopurinol 300 mg/day | Chronic allograft failure | 7.8 | ESKD | |
| No | 27 | 4 | 35 | DD | Allopurinol 150 mg twice-a-week, from day 36 post-Tx | Recurrence of DHA nephropathy 1 month post-Tx; died with a functioning graft | 1.4 | 15 | |
| 9 | Yes | 54 | 1 | 56 | DD | Allopurinol 300 mg/day for 7 years pre-Tx, subsequently 600 mg/day | Functioning graft | 13.3 | 50 |
| 10 | Yes | 46 | 1 | 46 | LUD | Allopurinol 400 mg/day for 3 years pre-Tx | Functioning graft | 4.4 | 71 |
| 11 | Yes | 43 | 1 | 47 | DD | Allopurinol 300 mg/day for 2 years pre-Tx | Functioning graft | 4.4 | 45 |
| 12 | Yes | 21 | 1 | 22 | LRD | Allopurinol 300 mg/day 1 year pre-Tx, later also febuxostat 120 mg/day | Graft lost due to recurrence of DHA nephropathy 5 years post-Tx | 5.2 | ESKD |
| Yes | 28 | 2 | 29 | LUD | Allopurinol 600 mg/day and febuxostat 120 mg/day | Functioning graft | 1.8 | 69 | |
| 13 | Yes | 36 | 1 | 41 | LRD | Allopurinol 200 mg/day for 1 month pre- Tx, subsequently 400 mg/day | Died with a functioning graft | 0.3 | 39 |
| 14 | Yes | 41 | 1 | 41 | DD | Allopurinol for 15 years pre-Tx, subsequently 600 mg/day | Functioning graft | 3.9 | 80 |
| 15 | Yes | 50 | 1 | 53 | LUD | Allopurinol for 2 years pre-Tx, subsequently 600 mg/day | Functioning graft | 2.8 | 65 |
| 16 | Yes | 42 | 1 | 47 | DD | Allopurinol 150 mg/day for 4 years pre-Tx, subsequently 300 mg/day and febuxostat 40 mg/day | Recurrence of DHA nephropathy 10 days post-Tx; functioning graft | 1.0 | 60 |
| 17 | Yes | 66 | 1 | 66 | DD | Allopurinol 200 mg/day for 12 years pre-Tx, subsequently 300 mg/day | Functioning graft | 2.1 | 82 |
Abbreviations: DD, deceased donor; LRD, living-related donor; LUD, living-unrelated donor; ESKD: end-stage kidney disease; RRT, renal replacement therapy; Tx, kidney transplantation.
The shaded area denotes allografts where xanthine oxidoreductase treatment was not initiated prior to kidney transplantation.