Thrombotic microangiopathy following pancreas after kidney transplants

Gerald S. Lipshutz, Phuong Chi T. Pham, R. Mark Ghobrial, William D. Wallace, Jeffrey M. Miller, Phuong Thu T. Pham

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Advances in immunosuppressive therapy and refinement in surgical techniques have allowed pancreas after kidney (PAK) transplantation to become a viable therapeutic option for patients with brittle type I diabetic recipients of a living donor or previous deceased kidney alone transplant. Although maintenance immunosuppressive therapy is not significantly changed after the addition of a pancreas, a temporary booster in immunosuppressive therapy and an increase in the dose of calcineurin inhibitor (CNI) are required after PAK transplantation. The latter has been implicated in the observed variable decline in kidney allograft function. We herein report two cases of kidney allograft dysfunction following PAK transplant due to biopsy-proven transplant, thrombotic microangiopathy (TMA). Whether PAK transplantation pre-disposes a subset of patients to the development of post-transplant TMA is not known. Diagnostic kidney biopsies should be considered in PAK transplant recipients with worsening kidney allograft function.

Original languageEnglish (US)
Pages (from-to)236-241
Number of pages6
JournalClinical Transplantation
Volume22
Issue number2
DOIs
StatePublished - Mar 1 2008

Keywords

  • Calcineurin inhibitor-induced thromboric microangiopathy
  • Pancreas after kidney transplants
  • Sirolimus-induced trombotic microangiopathy
  • Thrombotic microangiopathy

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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