Department of Nephrology, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
Clin Transplant. 2013 Jul-Aug;27(4):591-7. doi: 10.1111/ctr.12170.
Thrombotic microangiopathy (TMA) is a severe complication of kidney transplantation. TMA may occur de novo or as recurrent disease post-transplant. De novo disease is usually associated with immunosuppressive drugs or can be seen as a part of endothelial damage that accompanies antibody-mediated rejection. Treatment for de novo TMA is limited to plasma exchange and change in immunosuppression. We report two cases of de novo TMA post-transplant that were successfully treated by converting to belatacept for maintenance immunosuppression.
血栓性微血管病（TMA）是肾移植的严重并发症。TMA 可在移植后新发或作为复发性疾病出现。新发疾病通常与免疫抑制剂药物有关，也可视为伴随抗体介导排斥反应的内皮损伤的一部分。新发 TMA 的治疗仅限于血浆置换和改变免疫抑制。我们报告了两例移植后新发 TMA 病例，通过转换为贝利尤单抗进行维持性免疫抑制治疗取得了成功。
