Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Post-kidney transplant thrombotic microangiopathy (KT-TMA) is a poor prognostic complication that causes a high rate of graft loss. In this study, we investigated KT-TMA-associated complement factors and blood markers.
*Methods: Kidney transplant patients who had developed KT-TMA since 2010 were enrolled. Their blood samples were subjected to targeting genome sequencing of 136 complement-related genes by NGS and quantitative analysis of blood complement factors (sC5b-9, Ba, CFH, CFH-IgG, CFH, C5a, C3, C4, and CH50), and the patients’ clinical data were collected.
*Results: Eight KT-TMA patients from 5 hospitals were enrolled. The time after KT-TMA until blood sampling was a median of 24 months [range: <1 to 40 months]. Soring by donor, there was one deceased donor and 7 living donors, and all living kidney transplantations were ABO-incomparible. Further, six of seven patients did not undergo plasma exchange and/or double filtration plasmapheresis as a desensitizatation therapy. In the blood complement assay, plasma Ba, a factor B degradation product, in 7 KT-TMA patients was higher than the normal limits [median: 1,079 ng/mL(range: 730 to 6,768) v.s. normal range: 276 to 685]. Especially, levels in the two patients with graft loss was markedly high. In NGS analysis, we detected a new candidate mutation in CHFR1 of atypical HUS-responsible genes, but no common mutation, as well as other candidate gene mutations in 136 complement-related genes.
*Conclusions: Ba produced in an alternative pathway was a candidate KT-TMA blood maker. Further evaluation of candidate mutations is required to identity genes responsible for KT-TMA.
To cite this abstract in AMA style:Fujiyama N, Tasaki M, Harada H, Tsutahara K, Matsumoto A, Hara Y, Okumi M, Saito K, Watarai Y, Inoue N, Wakamiya N, Satoh S. Evaluation Of Complement-related Factors In Tma Post-kidney Transplantation: A Retrospective Multicenter Study [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/evaluation-of-complement-related-factors-in-tma-post-kidney-transplantation-a-retrospective-multicenter-study/. Accessed October 29, 2020.
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