{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:26Z","timestamp":1787015846278,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2016,6,24]],"date-time":"2016-06-24T00:00:00Z","timestamp":1466726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Transplantation\u2010associated thrombotic microangiopathy (TA\u2010TMA) is relatively rare and requires immediate intervention to avoid irreversible organ damage or death; however, consensus regarding the treatment approach is lacking. Atypical haemolytic uraemic syndrome (aHUS) is a rare disease caused by dysregulation of the alternative complement pathway resulting in TMA. aHUS is histologically similar to TA\u2010TMA; approximately 60% of TA\u2010TMA patients have complement dysregulation. Eculizumab, a humanized anti\u2010C5 monoclonal antibody, inhibits terminal membrane\u2010attack complex formation and TMA progression. Eculizumab has been successfully used to treat aHUS post\u2010transplant. We present two cases of kidney TA\u2010TMA due to unknown causes, suspected antibody\u2010mediated rejection, or calcineurin inhibitor (CNI)\u2010related toxicity that developed on day 1 or 2 post\u2010kidney transplantation. Low platelet count and haemoglobin level with red cell fragments were detected. Despite steroid pulse, plasma exchange (PE), and intravenous immunoglobulin therapy, TA\u2010TMA did not improve; therefore, eculizumab was administered despite no genetic testing. Laboratory data, including renal function, improved immediately. TA\u2010TMA treatment primarily involves PE initiation or CNI discontinuation; eculizumab can be used to safely treat TA\u2010TMA and then be ceased in the short term. Therefore, eculizumab administration might be beneficial for kidney TA\u2010TMA as early as the diagnosis of refractory to PE.<\/jats:p>","DOI":"10.1111\/nep.12768","type":"journal-article","created":{"date-parts":[[2016,3,12]],"date-time":"2016-03-12T14:06:36Z","timestamp":1457791596000},"page":"35-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Two cases of kidney transplantation\u2010associated thrombotic microangiopathy successfully treated with eculizumab"],"prefix":"10.1111","volume":"21","author":[{"given":"Takashi","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayoshi","family":"Okumi","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Unagami","sequence":"additional","affiliation":[{"name":"Internal Medicine, Kidney Center Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taichi","family":"Kanzawa","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anri","family":"Sawada","sequence":"additional","affiliation":[{"name":"Surgical Pathology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunio","family":"Kawanishi","sequence":"additional","affiliation":[{"name":"Surgical Pathology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Omoto","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2010.155"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0902814"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04252.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029615599439"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03156.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02297.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006080811"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02817.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.423"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21352"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061648"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003573"},{"key":"e_1_2_5_14_1","first-page":"27","article-title":"An update for atypical haemolytic uraemic syndrome: diagnosis and treatment. A consensus document","volume":"33","author":"Campistol JM","year":"2013","journal-title":"Nefrologia"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12032"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12768","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.12768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T17:31:56Z","timestamp":1695663116000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.12768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,24]]},"references-count":14,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1111\/nep.12768"],"URL":"https:\/\/doi.org\/10.1111\/nep.12768","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,24]]},"assertion":[{"value":"2016-06-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}