|
|||||
|
|
Thrombotic microangiopathy following pancreas after kidney transplants |
|
| Authors: | Lipshutz Gerald S Pham Phuong-Chi T Ghobrial Mark R Wallace William D Miller Jeffrey M Pham Phuong-Thu T |
| Affiliation: | Department of Surgery and Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles;, Nephrology Division, Department of Medicine, David Geffen School of Medicine at UCLA and Olive View-UCLA Medical Center, Sylmar;, Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles;, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles;, Division of Hematology and Oncology, David Geffen School of Medicine at UCLA and Olive View-UCLA Medical Center, Sylmar and;Kidney and Pancreas Transplantation, Nephrology Division, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA |
| Abstract: | Abstract: Advances in immunosuppressive therapy and refinement in surgical techniques have allowed pancreas after kidney (PAK) transplantation to become a viable therapeutic option for patients with brittle type I diabetic recipients of a living donor or previous deceased kidney alone transplant. Although maintenance immunosuppressive therapy is not significantly changed after the addition of a pancreas, a temporary booster in immunosuppressive therapy and an increase in the dose of calcineurin inhibitor (CNI) are required after PAK transplantation. The latter has been implicated in the observed variable decline in kidney allograft function. We herein report two cases of kidney allograft dysfunction following PAK transplant due to biopsy-proven transplant, thrombotic microangiopathy (TMA). Whether PAK transplantation pre-disposes a subset of patients to the development of post-transplant TMA is not known. Diagnostic kidney biopsies should be considered in PAK transplant recipients with worsening kidney allograft function. |
| Keywords: | calcineurin inhibitor-induced thrombotic microangiopathy pancreas after kidney transplants sirolimus-induced thrombotic microangiopathy thrombotic microangiopathy |
| 本文献已被 PubMed 等数据库收录！ | |