Question:
What is transplant associated thrombotic microangiopathy (TA-TMA)
Author: H KAnswer:
Postengraftement days(30 – 100) Occurs when endothelial damage resulting from HCT causes microangiopathic hemolytic anemia and platelet consumption, resulting in thrombosis and fibrin deposition in the microcirculation. The kidney is most commonly affected. Patients present with anemia; thrombocytopenia; often schistocytes on blood smear; elevated LDH and decreased haptoglobin Calcineurin inhibitors (especially + sirolimus), TBI, high-dose busulfan, and infections increase risk Early Evidence that eculizumab (terminal complement inhibitor) can improve renal function.
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