De novo thrombotic microangiopathy in two kidney transplant recipients from the same deceased donor: A case series

Roberts, Daniel A.; Siegman, Ingrid; Andeen, Nicole K.; Woodland, David C.; DeLoughery, Thomas G.; Rueda, Jose; Olyaei, Ali J.; Rehman, Shehzad; Norman, Doug; Lockridge, Joe

doi:10.1111/ctr.13885

Cited by 5 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It may also develop later, within a few years of transplantation, and presents more heterogeneous manifestations than aHUS. 22,23 A review of 15 870 kidney transplant recipients in the United States Renal Data System (USRDS) by Reynolds et al 24 revealed that the rates of de novo TMA vary from 1.1% to 14%. Langer et al reported an incidence of 1.5% for de novo TMA, wherein TMA was diagnosed based on the laboratory parameters.…”

Section: Diagnosis Of Tma In Kidney Transplant Patientsmentioning

confidence: 99%

“…Recently, Roberts et al 22 documented 2 cases of de novo TMA that occurred immediately following a kidney transplantation in patients who received a kidney graft from the same deceased donor. The authors speculated that deceased donor-related factors could be risk factors for the recipients developing de novo TMA.…”

Section: Amr-associated De Novo Tmamentioning

confidence: 99%

“…It may also develop later, within a few years of transplantation, and presents more heterogeneous manifestations than aHUS. 22,23…”

Section: Incidence Of De Novo Pt-tma In Kidney Transplantationmentioning

confidence: 99%

See 2 more Smart Citations

TMA in Kidney Transplantation

2023

View full text Add to dashboard Cite

Thrombotic microangiopathy (TMA) is a rare and devastating complication of kidney transplantation, which often leads to graft failure. Posttransplant TMA (PT-TMA) may occur either de novo or as a recurrence of the disease. De novo TMA can be triggered by immunosuppressant drugs, antibody-mediated rejection, viral infections, and ischemia/reperfusion injury in patients with no evidence of the disease before transplantation. Recurrent TMA may occur in the kidney grafts of patients with a history of atypical hemolytic uremic syndrome (aHUS) in the native kidneys. Studies have shown that some patients with aHUS carry genetic abnormalities that affect genes that code for complement regulators (CFH, MCP, CFI) and components (C3 and CFB), whereas in 10% of patients (mostly children), anti-FH autoantibodies have been reported. The incidence of aHUS recurrence is determined by the underlying genetic or acquired complement abnormality. Although treatment of the causative agents is usually the first line of treatment for de novo PT-TMA, this approach might be insufficient. Plasma exchange typically resolves hematologic abnormalities but does not improve kidney function. Targeted complement inhibition is an effective treatment for recurrent TMA and may be effective in de novo PT-TMA as well, but it is necessary to establish which patients can benefit from different therapeutic options and when and how these can be applied.

show abstract

Section: Diagnosis Of Tma In Kidney Transplant Patientsmentioning

confidence: 99%

Section: Amr-associated De Novo Tmamentioning

confidence: 99%

See 1 more Smart Citation

TMA in Kidney Transplantation

2023

View full text Add to dashboard Cite

show abstract

“…Outcomes range from transient renal dysfunction with mild clinical significance to acute renal failure requiring temporary dialysis therapy, potential allograft loss, and patient mortality. The outcome depends on the histopathological severity of the TMA, the promptness of the diagnosis, and the initiation of treatment [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Unveiling the Incidence and Graft Survival Rate in Kidney Transplant Recipients With De Novo Thrombotic Microangiopathy: A Systematic Review and Meta-Analysis

Hsiung,

Chen,

Wang

et al. 2024

Transpl Int

View full text Add to dashboard Cite

De novo thrombotic microangiopathy (TMA) is a rare and challenging condition in kidney transplant recipients, with limited research on its incidence and impact on graft survival. This study conducted a systematic review and meta-analysis of 28 cohorts/single-arm studies and 46 case series/reports from database inception to June 2022. In meta-analysis, among 14,410 kidney allograft recipients, de novo TMA occurred in 3.20% [95% confidence interval (CI): 1.93–4.77], with systemic and renal-limited TMA rates of 1.38% (95% CI: 06.5–2.39) and 2.80% (95% CI: 1.27–4.91), respectively. The overall graft loss rate of de novo TMA was 33.79% (95% CI: 26.14–41.88) in meta-analysis. This study provides valuable insights into the incidence and graft outcomes of de novo TMA in kidney transplant recipients.

show abstract

“…Although rare in kidney transplant recipients, with an incidence of 5.6 cases per 1000 renal transplant recipients per year, TMA is a serious complication in these patients. It associates with poor outcomes, both on kidney allograft and patient [3,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Primary Hyperaldosteronism: A Rare Cause of Malignant Hypertension with Thrombotic Microangiopathy in a Kidney Transplant Recipient

Ormonde

Querido

Rombo

et al. 2021

Case Reports in Transplantation

View full text Add to dashboard Cite

Thrombotic microangiopathy (TMA) is a rare disease that presents with haemolysis and organ damage. The kidney is one of the main affected organs, and TMA is associated with serious complications and increased mortality. In transplanted patients, TMA is even less common and has a variety of possible causes, including thrombotic thrombocytopenic purpura (TTP) and haemolytic-uremic syndrome (HUS), infections, drugs, autoimmune disease, tumours, and malignant hypertension. Transplant-related causes, such as antibody-mediated rejection, calcineurin inhibitors, and viral infections, need to be considered as well. The authors report a rare case of TMA in a kidney transplant recipient, whose investigation revealed malignant hypertension secondary to primary hyperaldosteronism.

show abstract

De novo thrombotic microangiopathy in two kidney transplant recipients from the same deceased donor: A case series

Cited by 5 publications

References 15 publications

TMA in Kidney Transplantation

TMA in Kidney Transplantation

Unveiling the Incidence and Graft Survival Rate in Kidney Transplant Recipients With De Novo Thrombotic Microangiopathy: A Systematic Review and Meta-Analysis

Primary Hyperaldosteronism: A Rare Cause of Malignant Hypertension with Thrombotic Microangiopathy in a Kidney Transplant Recipient

Contact Info

Product

Resources

About