Use of Belatacept as Alternative Immunosuppression in Three Renal Transplant Patients with De Novo Drug-Induced Thrombotic Microangiopathy
Joint Authors
Roberti, Javier
Paz, Marta
Mos, Fernando
Cicora, Federico
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-10-01
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Thrombotic microangiopathy (TMA), a severe complication of renal transplantation, is a pathological process involving microvascular occlusion, thrombocytopenia, and microangiopathic hemolytic anemia.
It generally appears within the first weeks after transplantation, when immunosuppressive drugs are used at high doses.
De novo TMA may also be drug-induced when calcineurin inhibitors or proliferation signal inhibitors are used.
We report three cases of de novo drug-induced TMA in renal transplant patients who were managed by replacing calcineurin inhibitors or proliferation signal inhibitors with belatacept, a primary maintenance immunosuppressive drug, which blocks the CD28 costimulation pathway, preventing the activation of T lymphocytes.
To identify the cause of TMA, we ruled out HUS, hepatitis C serology, HIV serology, parvovirus B19, cytomegalovirus, anti-HLA antibodies, and prolonged activated partial thromboplastin time.
We suspect that the TMA was caused by the calcineurin inhibitors or proliferation signal inhibitors.
Belatacept treatment was initiated at a dose of 10 mg/kg on days 1, 5, 14, 28, 60, and 90; maintenance treatment was 5 mg/kg once a month for 1 year.
Belatacept, in combination with other agents, prevented graft rejection in three patients.
American Psychological Association (APA)
Cicora, Federico& Paz, Marta& Mos, Fernando& Roberti, Javier. 2013. Use of Belatacept as Alternative Immunosuppression in Three Renal Transplant Patients with De Novo Drug-Induced Thrombotic Microangiopathy. Case Reports in Medicine،Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-458251
Modern Language Association (MLA)
Cicora, Federico…[et al.]. Use of Belatacept as Alternative Immunosuppression in Three Renal Transplant Patients with De Novo Drug-Induced Thrombotic Microangiopathy. Case Reports in Medicine No. 2013 (2013), pp.1-4.
https://search.emarefa.net/detail/BIM-458251
American Medical Association (AMA)
Cicora, Federico& Paz, Marta& Mos, Fernando& Roberti, Javier. Use of Belatacept as Alternative Immunosuppression in Three Renal Transplant Patients with De Novo Drug-Induced Thrombotic Microangiopathy. Case Reports in Medicine. 2013. Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-458251
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-458251