Photo Credit: ibreakstock
The following is a summary of “Outcome of thrombotic microangiopathy in kidney transplant recipients,” published in the November 2024 issue of Nephrology by Haq et al.
Researchers conducted a prospective study on kidney transplant recipients with a history of complement-mediated thrombotic microangiopathy (cTMA) and post-transplant develop post-transplant de novo TMA (dnTMA), finding their outcomes and risks remain unclear.
They analyzed data from kidney transplant recipients with ESKD due to cTMA or dnTMA between January 2000 and December 2020 at their center.
The results showed 134 patients, 22 with cTMA and 112 with dnTMA. Patients with cTMA were younger at diagnosis (28.9 ± 16.3 vs. 46.5 ± 16.0 years; P < 0.001). dnTMA had more T-cell rejection, borderline rejection, and calcineurin inhibitor toxicity (P < 0.05), while antibody-mediated rejection was higher in anytime biopsies (P = 0.027). cTMA increased transplant failure risk sixfold in the first year (adjusted hazard ratio (aHR): 6.37; 95%CI: 2.17–18.68; P = 0.001), with a 0.87 decrease in aHR per year since transplant (95%CI: 0.76–0.99; P = 0.033). Long-term survival was similar in both groups.
They concluded that post-kidney transplant TMA significantly contributed to poor allograft survival. Further studies were needed to improve understanding and management of this disorder.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03846-x
