Abstract: TH-PO577
Short Eculizumab Administration in the Treatment of De Novo Thrombotic Microangiopathy (TMA) in Kidney Transplant: Case Series
Session Information
- Trainee Case Reports - II
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Trainee Case Reports
- 1802 Transplantation: Clinical
Authors
- Angeletti, Andrea, University of Bologna, Bologna, Italy
- Spazzoli, Alessandra, University of Bologna, Bologna, Italy
- Baraldi, Olga, University of Bologna, Bologna, Italy
- Cuna, Vania, University of Bologna, Bologna, Italy
- Corradetti, Valeria, University of Bologna, Bologna, Italy
- Comai, Giorgia, University of Bologna, Bologna, Italy
- La Manna, Gaetano, University of Bologna, Bologna, Italy
Introduction
De novo TMA adversely affects kidney transplant recipient and allograft survival. It remains unknown why only a relatively small percentage of the renal transplant recipients develop TMA. Complement activation is the common denominator in this condition. Eculizumab, a humanized monoclonal antibody targeted against complement C5, has been showed to be effective in the treatment of de novo TMA. How long the treatment have to be maintained is debated. We report the description of a prospective cohort of 10 patients primary treated with eculizumab (1 or 2 infusion) for de novo TMA after transplantation.
Case Description
All the recipients were transplanted with compatible ABO. The cohort were homogenous for age, sex, cold ischemic storage, inductive and mantainance imunosuppresive therapies.
Diagnosis of de novo TMA was established by the founding of the triad: microangiopathic hemolytic anemia, thrombocytopenia and worsening of kidney function, excluding other potential secondary causes, as suggested in the literature. We performed kidney biopsies in 3 cases (Figure 1). All the subjects developed de novo TMA in the first week after transplantation. Eculizumab (600 mg) was administered once or twice based on lab findings at 1 week after infusion. TMA remission and impoved of kindey function were obtained in 9 patients (Figure 2).
Discussion
Eculizumab can be used to safely treat de novo TMA and also with efficacy, even if ceased in the short term.