Successful conversion to belatacept after thrombotic microangiopathy in kidney transplant patients.
Thrombotic microangiopathy (TMA) is a severe complication of kidney transplantation. TMA may occur de novo or as recurrent disease post-transplant. De novo disease is usually associated with immunosuppressive drugs or can be seen as a part of endothelial damage that accompanies antibody-mediated rejection. Treatment for de novo TMA is limited to plasma exchange and change in immunosuppression. We report two cases of de novo TMA post-transplant that were successfully treated by converting to belatacept for maintenance immunosuppression.
Department of Nephrology, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
Sireesha
S
Koppula
Sarah E
SE
Yost
Amy
A
Sussman
Erika R
ER
Bracamonte
Bruce
B
Kaplan
D000069594:Abatacept; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D011379:Prognosis; D012307:Risk Factors; D057049:Thrombotic Microangiopathies / Q000188:drug therapy* / Q000209:etiology
D018796:Immunoconjugates; D007166:Immunosuppressive Agents; D000069594:Abatacept
belatacept; renal transplantation; tacrolimus; thrombotic microangiopathy