Format

Send to

Choose Destination
See comment in PubMed Commons below
Nephrology (Carlton). 2014 Apr;19(4):177-85. doi: 10.1111/nep.12217.

Antiphospholipid syndrome in renal transplantation.

Author information

  • 1Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Abstract

Antiphospholipid syndrome (APS) may occur in isolation or in association with systemic lupus erythematosus (SLE), with the potential to cause renal failure via several distinct pathologies. Renal transplantation in the presence of APS carries a risk of early graft loss from arterial or venous thrombosis, or thrombotic microangiopathy (TMA). Whilst perioperative anticoagulation reduces the risk of large vessel thrombosis, it may result in significant haemorrhage, and its efficacy in preventing post-transplant TMA is uncertain. Here, we report a patient with end-stage kidney disease (ESKD) due to lupus nephritis and APS, in whom allograft TMA developed soon after transplantation despite partial anticoagulation. TMA resolved with plasma exchange-based therapy albeit with some irreversible graft damage and renal impairment. We discuss the differential diagnosis of post-transplant TMA, and current treatment options.

© 2014 Asian Pacific Society of Nephrology.

KEYWORDS:

antiphospholipid; lupus; plasma exchange; thrombotic microangiopathy

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Write to the Help Desk