A CASE SERIES OF POST TRANSPLANT THROMBOTIC MICROANGIOPATHY

Thrombotic microangiopathy (TMA) is a histo pathological term that is used to define glomerular, arteriolar and arterial lesions with patchy involvement. It is characterized by mesangiolysis, fibrin thrombi, splitting of capillary basement membrane and cortical necrosis. Two forms of post-transplant TMA are described namely recurrent disease and de novo TMA. TMA is a serious complication in renal transplant recipients that often leads to graft dysfunction. We present six renal transplant recipients who developed de novo TMA. Our cases were treated by interchanging the calcineurin inhibitors (CNI) and plasmapheresis in 2 cases. On follow up, 2 patients developed permanent graft dysfunction and become dialysis dependent.