Bonsib S M, Ercolani L, Ngheim D, Hamilton H E
Am J Med. 1985 Oct;79(4):520-7. doi: 10.1016/0002-9343(85)90043-9.
Thrombotic microangiopathy in a renal allograft may either reflect a recurrence of the patient's original disease, i.e., thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome, or more commonly may be a manifestation of allograft rejection. This report describes a patient in whom irreversible renal failure developed during thrombotic thrombocytopenic purpura. Two years later while her condition was in clinical remission, she received a 2 DR-matched cadaveric allograft. Nineteen days following transplantation, thrombotic microangiopathy developed in the graft with eventual loss of allograft function despite vigorous plasmapheresis therapy. Multiple factors in addition to possible recurrent disease that may have contributed to this event were identified. The literature on thrombotic microangiopathy and renal transplantation is reviewed.
同种异体肾移植中的血栓性微血管病可能反映患者原发病的复发，即血栓性血小板减少性紫癜、溶血尿毒综合征，或者更常见的是同种异体移植排斥反应的一种表现。本报告描述了一名在血栓性血小板减少性紫癜期间发生不可逆肾衰竭的患者。两年后，当她的病情处于临床缓解期时，接受了一个2个DR位点匹配的尸体同种异体肾移植。移植后19天，移植肾发生血栓性微血管病，尽管进行了积极的血浆置换治疗，最终移植肾功能仍丧失。除了可能的复发性疾病外，还确定了可能导致这一事件的多个因素。本文对血栓性微血管病与肾移植的相关文献进行了综述。
