Thrombotic microangiopathy after kidney transplantion

Background and objectives: Thrombotic microangiopathy after kidney transplantation is rare but serious complication. The purpose of this study is to describe the cases of thrombotic microangiopathy after kidney transplantation. Patients and Methods: This retrospective study used the reports of all kidney transplant biopsies that were done in Kurdistan region from January 2017 to April 2022. The biopsy reports with diagnosis of Thrombotic microangiopathy were extracted from this total number and the patients, and pathological data included in the reports were recorded. Results: The total number of 1635 graft biopsies, of which 82 (5.01%) were found to have Thrombotic microangiopathy features. The mean age of studied patients with Thrombotic microangiopathy was (38.2 years) and male to female ratio as 2.3:1. We found 67.1% of cases of Thrombotic microangiopathy were associated with calcineurin inhibitor toxicity, 35.4% with rejection, 15.9% were recurrent thrombotic microangiopathy, and 40.2% were associated with other miscellaneous causes. Conclusions: Thrombotic microangiopathy after kidney transplantation is rare but debilitating complication. The cause is multifactorial in most cases in the light of coexistence of multiple risk factors in the kidney transplant recipients. Further studies are required to disentangle these overlapping risk factors. And allow for better prevention and treatment of this condition.