Early graft loss due to acute thrombotic microangiopathy accompanied by complement gene variants in living-related kidney transplantation: case series report

Autor: Qianqian Wu, Xiaohui Tian, Nianqiao Gong, Jin Zheng, Dandan Liang, Xue Li, Xia Lu, Wujun Xue, Puxun Tian, Jiqiu Wen
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Nephrology, Vol 23, Iss 1, Pp 1-8 (2022)
Druh dokumentu: article
ISSN: 1471-2369
DOI: 10.1186/s12882-022-02868-7
Popis: Abstract Background Recently, early graft loss has become very rare in living-related kidney transplantation (LKT) as a result of decreased risk of hyperacute rejection and improvements in immunosuppressive regimens. Post-transplant acute thrombotic microangiopathy (TMA) is a rare, multi-factorial disease that often occurs shortly after kidney transplantation and is usually resistant to treatment with dismal renal outcomes. The complement genetic variants may accelerate the development of TMA. However, the complement genetic test was seldom performed in unknown native kidney disease recipients scheduled for LKT. Case presentation We reported three cases of unknown native kidney diseases who had fulminant TMA in the allograft shortly after LKT. Both the donors and the recipients were noted to carry complement genetic variants, which were identified by genetic testing after transplantation. However, all recipients were refractory to treatment and had allograft loss within 3 months after LKT. Conclusion This case series highlights the suggestion to screen complement gene variants in both the donors and the recipients with unknown native kidney diseases scheduled for LKT.
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