Characteristics and management of thrombotic microangiopathy in kidney transplantation
Thrombotic microangiopathy is not a rare complication of kidney transplantation and is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury with extensive thrombosis of the arterioles and capillaries. Various factors can cause thrombotic microangiopathy after...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2023-03-01
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| Series: | Korean Journal of Transplantation |
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| Online Access: | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0011 |
| _version_ | 1827360730278526976 |
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| author | Wonyong Cho Sang-Kyung Jo Cheol Woong Jung Myung-Gyu Kim |
| author_facet | Wonyong Cho Sang-Kyung Jo Cheol Woong Jung Myung-Gyu Kim |
| author_sort | Wonyong Cho |
| collection | DOAJ |
| description | Thrombotic microangiopathy is not a rare complication of kidney transplantation and is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury with extensive thrombosis of the arterioles and capillaries. Various factors can cause thrombotic microangiopathy after kidney transplantation, including surgery, warm and cold ischemia-reperfusion injury, exposure to immunosuppressants, infection, and rejection. Many recent studies on atypical hemolytic uremic syndrome have described genetic abnormalities related to excessive activation of the alternative complement pathway. The affected patients’ genetic backgrounds revealed significant genetic heterogeneity in several genes involved in complement regulation, including the complement factor H, complement factor H-related proteins, complement factor I, complement factor B, complement component 3, and CD46 genes in the alternative complement pathway. Although clinical studies have provided a better understanding of the pathogenesis of diseases, the diverse triggers present in the transplant environment can lead to thrombotic microangiopathy, along with various genetic predispositions, and it is difficult to identify the genetic background in various clinical conditions. Given the poor prognosis of posttransplant thrombotic microangiopathy, further research is necessary to improve the diagnosis and treatment protocols based on risk factors or genetic predisposition, and to develop new therapeutic agents. |
| first_indexed | 2024-03-08T06:52:35Z |
| format | Article |
| id | doaj.art-f9d8090a82b247509000596b59143618 |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T06:52:35Z |
| publishDate | 2023-03-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-f9d8090a82b247509000596b591436182024-02-03T06:45:51ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902023-03-01371111810.4285/kjt.23.0011kjt.23.0011Characteristics and management of thrombotic microangiopathy in kidney transplantationWonyong Cho0Sang-Kyung Jo1Cheol Woong Jung2Myung-Gyu Kim3Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, KoreaDepartment of Transplantation and Vascular Surgery, Korea University Anam Hospital, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, KoreaThrombotic microangiopathy is not a rare complication of kidney transplantation and is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury with extensive thrombosis of the arterioles and capillaries. Various factors can cause thrombotic microangiopathy after kidney transplantation, including surgery, warm and cold ischemia-reperfusion injury, exposure to immunosuppressants, infection, and rejection. Many recent studies on atypical hemolytic uremic syndrome have described genetic abnormalities related to excessive activation of the alternative complement pathway. The affected patients’ genetic backgrounds revealed significant genetic heterogeneity in several genes involved in complement regulation, including the complement factor H, complement factor H-related proteins, complement factor I, complement factor B, complement component 3, and CD46 genes in the alternative complement pathway. Although clinical studies have provided a better understanding of the pathogenesis of diseases, the diverse triggers present in the transplant environment can lead to thrombotic microangiopathy, along with various genetic predispositions, and it is difficult to identify the genetic background in various clinical conditions. Given the poor prognosis of posttransplant thrombotic microangiopathy, further research is necessary to improve the diagnosis and treatment protocols based on risk factors or genetic predisposition, and to develop new therapeutic agents.http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0011thrombotic microangiopathy; atypical hemolytic uremic syndrome; kidney transplantation |
| spellingShingle | Wonyong Cho Sang-Kyung Jo Cheol Woong Jung Myung-Gyu Kim Characteristics and management of thrombotic microangiopathy in kidney transplantation Korean Journal of Transplantation thrombotic microangiopathy; atypical hemolytic uremic syndrome; kidney transplantation |
| title | Characteristics and management of thrombotic microangiopathy in kidney transplantation |
| title_full | Characteristics and management of thrombotic microangiopathy in kidney transplantation |
| title_fullStr | Characteristics and management of thrombotic microangiopathy in kidney transplantation |
| title_full_unstemmed | Characteristics and management of thrombotic microangiopathy in kidney transplantation |
| title_short | Characteristics and management of thrombotic microangiopathy in kidney transplantation |
| title_sort | characteristics and management of thrombotic microangiopathy in kidney transplantation |
| topic | thrombotic microangiopathy; atypical hemolytic uremic syndrome; kidney transplantation |
| url | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0011 |
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