Progress on diagnosis and treatment of kidney transplantation-associated thrombotic microangiopathy
10.3969/j.issn.1674-7445.2023.01.009
- VernacularTitle:肾移植相关血栓性微血管病的诊断及治疗进展
- Author:
Dawei LI
1
;
Ming ZHANG
Author Information
1. Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China
- Publication Type:Research Article
- Keywords:
Kidney transplantation;
Thrombotic microangiopathy;
Atypical hemolytic uremic syndrome;
Thrombotic thrombocytopenic purpura;
Immunosuppressant;
Infection;
Antibody-mediated rejection;
Ecurizumab
- From:
Organ Transplantation
2023;14(1):68-
- CountryChina
- Language:Chinese
-
Abstract:
Thrombotic microangiopathy (TMA) is a severe complication after kidney transplantation, mainly characterized by thrombocytopenia, microvascular hemolytic anemia and acute kidney injury, which may lead to kidney allograft failure or even death of the recipients. With the increasing quantity of solid organ transplantation in China and deeper understanding of TMA, relevant in-depth studies have been gradually carried out. Kidney transplantation-associated TMA is characterized with different causes and clinical manifestations. Non-invasive specific detection approach is still lacking. The diagnosis of TMA mainly depends on renal biopsy. However, most TMA patients are complicated with significant thrombocytopenia. Hence, renal puncture is a risky procedure. It is difficult to make a definite diagnosis. For kidney transplantation-associated TMA, plasma exchange, intravenous immunoglobulin and withdrawal of potential risk drugs are commonly employed. Nevertheless, the overall prognosis is poor. In this article, the classification of TMA after kidney transplantation, diagnosis and treatment of kidney transplantation-associated TMA were reviewed, aiming to provide reference for clinical diagnosis and treatment of kidney transplantation-associated TMA.
