Kidney transplant associated acute thrombotic microangiopathy
Research type
Research Study
Full title
Clinico-pathological correlations of acute thrombotic microangiopathy in transplant renal biopsies
IRAS ID
159614
Contact name
Verena Broecker
Contact email
Duration of Study in the UK
0 years, 7 months, 1 days
Research summary
Following kidney transplantation, patients can develop thrombosis in renal glomeruli or small arteries (transplant associated acute thrombotic microangiopathy - aTMA-tx), which may adversely affect the transplant outcome. The underlying cause of aTMA-tx, however, is often difficult to determine at the time of biopsy.
Acute TMA in kidney transplants has been reported in 1-14% of transplant kidney biopsies. Recurrence of the primary kidney disease such as atypical haemolytic uraemic syndrome or antiphospholipid syndrome as well as de novo aTMA-tx occurs in renal transplants. Predominant underlying conditions in de novo aTMA-tx include acute rejection (in particular mediated by antibodies against the allograft: Antibody mediated rejection - AMR) or immunosuppressive drug toxicity (calcineurin inhibitor (CNI) toxicity). Frequently, aTMA-tx is clinically silent, underscoring the necessity of a biopsy to guide clinical management.
In order to identify pathological differences between different forms of aTMA-tx we are aiming to review all transplant renal biopsies with glomerular and/or arteriolar thrombi between 2007 and 2013. The index biopsy will be defined as the first biopsy showing aTMA-tx. Sequential biopsies taken before or after the index biopsy will also be evaluated to gain information on the time course of the disease and to help to identify features suggestive of an underlying cause that may have been obscure in the index biopsy.REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
14/EM/1245
Date of REC Opinion
10 Nov 2014
REC opinion
Favourable Opinion