title: A national specialized service in England for atypical haemolytic uraemic syndrome-the first year's experience.
abstract: BACKGROUND
  In 2013 NHS England commissioned the use of eculizumab for both new patients with atypical haemolytic uraemic syndrome (aHUS) and those undergoing transplantation. This national service is delivered locally but coordinated by an expert centre at the Newcastle upon Tyne Hospitals NHS Foundation Trust.
  
  
  RESULTS
  In the first year of service, 43 aHUS patients received eculizumab, 15 children and 28 adults. Twenty-three were new patients and 20 prevalent. Fifteen of the 23 new patients required dialysis before eculizumab was started, 8 of these recovered renal function. Twelve of the 20 prevalent patients who received eculizumab were transplant patients, 8 with prophylactic use and 4 for recurrent disease; the outcome in all was good. Eculizumab was withdrawn in 14 patients, 5 were patients who had not recovered renal function. In 3 of the 14 patients, it was necessary to reintroduce eculizumab because of recurrent disease (2 extra-renal and 1 renal). There were 2 deaths in the 43 patients, and neither was associated with use of eculizumab. There were no episodes of meningococcal disease.
  
  
  CONCLUSIONS
  The establishment of this national service has enabled aHUS patients in England to receive eculizumab when they need it for as long as they need it.
authors.affiliation: From the Institute of Cellular Medicine, the Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK t.h.j.goodship@ncl.ac.uk.
authors.forename: N S
authors.initials: NS
authors.lastname: Sheerin
authors.affiliation: the Institute of Genetic Medicine Newcastle University and the Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK t.h.j.goodship@ncl.ac.uk.
authors.forename: D
authors.initials: D
authors.lastname: Kavanagh
authors.affiliation: the Institute of Genetic Medicine Newcastle University and the Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK t.h.j.goodship@ncl.ac.uk.
authors.forename: T H J
authors.initials: TH
authors.lastname: Goodship
authors.affiliation: the Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK t.h.j.goodship@ncl.ac.uk.
authors.forename: S
authors.initials: S
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D065766:Atypical Hemolytic Uremic Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008589:Meningococcal Infections / Q000517:prevention & control; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C481642:eculizumab