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World J Transplant. Mar 18, 2024; 14(1): 90277
Published online Mar 18, 2024. doi: 10.5500/wjt.v14.i1.90277
Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra
Muhammed Mubarak, Amber Raza, Rahma Rashid, Fnu Sapna, Shaheera Shakeel
Muhammed Mubarak, Rahma Rashid, Shaheera Shakeel, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Amber Raza, Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Fnu Sapna, Department of Pathology, Montefiore Medical Center, The University Hospital for Albert Einstein School of Medicine, Bronx, NY 10461, United States
Author contributions: Mubarak M, Raza A, Rashid R, Sapna F, Shakeel S contributed equally to this work; Mubarak M and Raza A designed the research study; Mubarak M, Raza A, Rashid R, Sapna F, Shakeel S performed the research; Mubarak M and Raza A wrote the manuscript; Mubarak M, Raza A, Rashid R, Sapna F, Shakeel S have read and approve the final manuscript.
Conflict-of-interest statement: All authors have no conflict-of-interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, MD, Professor, Department of Pathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. drmubaraksiut@yahoo.com
Received: November 29, 2023
Peer-review started: November 29, 2023
First decision: January 15, 2024
Revised: January 28, 2024
Accepted: March 4, 2024
Article in press: March 4, 2024
Published online: March 18, 2024
Processing time: 107 Days and 1.1 Hours
Core Tip

Core Tip: Thrombotic microangiopathy (TMA) is a pattern of microvascular injury characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and multi-organ dysfunction. It is not a specific disease but rather a clinicopathological syndrome associated with numerous causes and conditions. It can also involve kidney allograft and can lead to graft dysfunction and loss. Posttransplant-TMA is distinct from native kidney TMA in certain respects and poses significant diagnostic and therapeutic challenges. A thorough understanding of the condition and the development of consensus-based diagnostic criteria are imperative for an early diagnosis and timely treatment to achieve best patient outcomes.