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KMID : 0361120160300010038
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Korean Journal of Transplantation
2016 Volume.30 No. 1 p.38 ~ p.43
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Overcome of Drug Induced Thrombotic Microangiopathy after Kidney Transplantation by Using Belatacept for Maintenance Immunosuppression
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Yun Sung-Han
Lee Jin-Ho
Oh Joon-Seok
Kim Sung-Min
Shin Yong-Hun
Kim Yong-Jin
Kim Joong-Kyung
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Abstract
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Thrombotic microangiopathy (TMA) is a serious complication of solid organ transplantation. Drug-induced TMA is typically caused by immunosuppressants, particularly calcineurin inhibitors. Withdrawing the causative drug can be one of the treatments for TMA. However, the more immunosuppressants are reduced, the more risk of rejection increases. Even if TMA is successfully resolved, the outcomes of patient and graft survival would be worse than expected. Therefore, it is necessary to maintain efficient and safe immunosuppression therapy. We report on a case of de novo TMA after kidney transplantation triggered by tacrolimus and reactivated by sirolimus. Belatacept, a novel CTLA4 Ig fusion protein, was administered for maintenance immunosuppressant with mycophenolate mofetil and prednisolon. The patient had excellent early graft outcome, and there have been no adverse events so far.
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KEYWORD
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Belatacept, Kidney transplantation, Thrombotic microangiopathies
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