case_images: PMC5763091_01
case_images: Kidney function (a), isoagglutinin titers (b), and hematological parameters (c) in patient 1. Evolution after kidney transplantation.
case_images: CRIT2017-3197042.001.jpg
case_images: PMC5763091_01_CRIT2017-3197042.001.jpg
case_images: fig1
case_images: At that time, serum creatinine level was 546 mumol/L (Figure 1).
case_images: PMC5763091_02
case_images: Kidney function (a), isoagglutinin titers (b), and hematological parameters (c) in patient 2. Evolution after transplantation.
case_images: CRIT2017-3197042.002.jpg
case_images: PMC5763091_02_CRIT2017-3197042.002.jpg
case_images: fig2
case_images: At POD 1, the patient presented with biological features of TMA, including hemolytic anemia, thrombocytopenia (platelet count at 49,000/mm3), and no improvement in kidney function (Figure 2). Rapidly after initiation of eculizumab, hematological parameters improved, as well as kidney function (Figure 2).
case_images: (a) Kidney allograft biopsy at postoperative day 12 in patient 2: thrombotic microangiopathy lesions, antibody-mediated rejection (t0, i0, g3, and cpt2). (b) Kidney allograft biopsy at postoperative day 54 in patient 2. Lesions of mixed acute cellular and antibody-mediates rejection (i2 i2 ti2 g2 cpt2), IF/TA 1, and no more lesions of thrombotic microangiopathy.
case_images: CRIT2017-3197042.003.jpg
case_images: PMC5763091_02_CRIT2017-3197042.003.jpg
case_images: fig3
case_images: A first kidney biopsy was done on POD 12 (Figure 3(a)) and revealed thrombotic microangiopathy, glomerulitis (g3), peritubular capillaritis (cpt2), and a peritubular C4d deposition. TMA lesions (Figure 3(b)). Three methylprednisolone pulses were given and immunoabsorption sessions were restarted (2 session/week for 6 weeks).