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Title: Thrombotic microangiopathy following intestinal transplantation: a single center experience
Authors: Dierickx, D ×
Monbaliu, Diethard
De Rycke, Anja
Wisanto, E
Lerut, Evelyne
Devos, Timothy
Meers, S
Darius, T
Ferdinande, Patrick
Pirenne, Jacques #
Issue Date: Jan-2010
Publisher: Appleton & Lange
Series Title: Transplantation Proceedings vol:42 issue:1 pages:79-81
Abstract: BACKGROUND: Transplant-related thrombotic microangiopathy (TMA) is a well-recognized complication of all types of transplantations. Despite its known relationship with immunosuppressive therapy, only a few cases have been reported following intestinal transplantation. METHODS: We retrospectively reviewed the medical files of nine consecutive intestinal transplant patients between 2000 and 2008. RESULTS: The diagnosis of TMA was established in 3 patients (33%). At diagnosis the immunosuppressive therapy consisted of tacrolimus (n = 3), combined with azathioprine (n = 1) or sirolimus (n = 2) and steroids (n = 2). The median time between transplantation and TMA was 104 days (range, 55-167 days). Levels of ADAMTS13, a von Willebrand protease, were within normal ranges in all 3 patients. Treatment consisted of stopping/tapering of tacrolimus, together with initiation of plasma therapy, leading to complete remission in all 3 patients. During further follow-up, all 3 patients showed severe graft rejection necessitating more profound immunosuppressive therapy, leading to graft loss in 1 patient and infection-related death in the 2 others. At a median follow-up of 52 months (range, 9-100 months) all remaining TMA-free patients (n = 6) were alive with functioning grafts under minimal immunosuppression. CONCLUSION: Herein we have described 3 intestinal transplant patients who were diagnosed with transplantation-related TMA. Despite excellent disease control the final outcomes were dismal, which clearly contrasts with the outcome among TMA-free patients, who were all well with functioning grafts at last follow-up.
URI: 
ISSN: 0041-1345
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Translational Cell & Tissue Research
Laboratory of Abdominal Transplantation
Clinical Residents Medicine
Hematology Section (-)
Laboratory of Intensive Care Medicine
Laboratory of Experimental Transplantation
Laboratory of Nephrology
× corresponding author
# (joint) last author

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