Clinical Nephrology · 2014 · 35 citations · 0 references
MedicineNephrologyPharmacotherapyImmunotherapyKidney TransplantationTransplant ImmunologyAllograft RejectionImmunosuppressionImmunosuppression In Kidney TransplantationImmunosuppressive TherapyTransplant PharmacologyTransplant RejectionComplement-mediated Thrombotic MicroangiopathyEculizumab TherapyImmunosuppression RegimensPost-transplant ImmunosuppressionRenal Transplant CareThrombotic Complications After TransplantationTransplant-associated Thrombotic MicroangiopathyTransplantation
De novo thrombotic microangiopathy (TMA) following renal transplantation is a severe complication associated with high rates of allograft failure. Several immunosuppressive agents are associated with TMA. Conventional approaches to managing this entity, such as withdrawal of the offending agent and/or plasmapheresis, often offer limited help, with high rates of treatment failure and graft loss. We herein report a case of drug induced de novo TMA successfully treated using the C5a inhibitor eculizumab in a renal transplant patient. This report highlights a potentially important role for eculizumab in settings where drug-induced de novo TMA is refractory to conventional therapies.