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Kidney Week

Abstract: PO2570

Does Therapeutic Plasma Exchange Improve Kidney Function in Renal Transplant-Associated Thrombotic Microangiopathy?

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Nahmod, Karen Amelia, University of Texas Medical Branch at Galveston, Galveston, Texas, United States
  • Bryant, Barbara J., University of Texas Medical Branch at Galveston, Galveston, Texas, United States
  • Yates, Sean G., University of Texas Medical Branch at Galveston, Galveston, Texas, United States
  • Afrouzian, Marjan, University of Texas Medical Branch at Galveston, Galveston, Texas, United States
Background

Therapeutic plasma exchange (TPE) is performed in patients with renal transplant thrombotic microangiopathy (t-TMA) to improve the kidney function. The goal of our study is to evaluate the short-term efficacy of TPE in patients with renal t-TMA.

Methods

We retrospectively compared the outcome of TPE-treated vs. non-TPE-treated patients with biopsy-proven diagnosis of t-TMA. Histologic criteria for diagnosis of t-TMA included presence of thrombi in the artery/arteriole/glomeruli, mesangiolysis & double contours, and electron microscopic evidence endothelial cell injury including subendothelial rarefaction/ accumulation of fluffy material and mesangial interposition. Both groups received concomitantly other modalities of treatment. Creatinine and creatinine clearance levels were determined at the time of biopsy (T0) and after 1, 3 and 6-months (T1, T3, T6 respectively).

Results

In 13 TPE-treated and 9 non-TPE-treated patients, the mean creatinine levels at 6 months decreased 32.5% and 45% respectively over baseline, while the creatinine clearance increased by 68% and 65% respectively, although not statistically significant (p>0.05) Graph1.

Conclusion

No significant differences were noted in creatinine or creatinine clearance levels within and between either groups at any time point. Our study suggest that no significant benefit in renal function is associated with performing TPE in patients with renal t-TMA. Larger studies are needed to confirm our data.