{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:32:37Z","timestamp":1753878757941,"version":"3.41.2"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transplant\u2010associated thrombotic microangiopathy (TA\u2010TMA) is an under\u2010recognized yet potentially devastating complication of hematopoietic stem cell transplantation (HSCT) which had increased awareness in recent years. This report summarizes the demographics and outcomes of pediatric TA\u2010TMA in Hong Kong.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients aged below 18\u2009years who underwent HSCT in the Hong Kong Children's Hospital and were diagnosed to have TA\u2010TMA during the 2\u2010year period from April 1, 2019 to March 31, 2021 were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 73 transplants (51 allogeneic and 22 autologous) in 63 patients had been performed. Six patients (four males and two females) developed TA\u2010TMA at a median duration of 2.5\u2009months post\u2010HSCT. The incidence rate was 9.52%. Of the six TA\u2010TMA patients, five underwent allogenic one underwent autologous HSCT, respectively. Three of them were histologically proven. All four patients with cyclosporine had stopped the drug once TA\u2010TMA was suspected. Median six doses of eculizumab were administered to five out of six patients. Three patients died (two due to fungal infection and one due to acute\u2010on\u2010chronic renal failure) within 3\u2009months upon diagnosis of TA\u2010TMA. Among three survivors, two stabilized with mild stage 2 chronic kidney disease (CKD) while the other suffered from stage 5 end\u2010stage CKD requiring lifelong dialysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, recognition and diagnosis of TA\u2010TMA are challenging. Early recognition and prompt administration of complement blockage with eculizumab may be beneficial in selected cases. Further prospective research studies are recommended to improve the management and outcomes of TA\u2010TMA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14366","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T08:00:38Z","timestamp":1658390438000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Epidemiology and outcomes of pediatric transplant\u2010associated thrombotic microangiopathy in Hong Kong"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4178-2777","authenticated-orcid":false,"given":"Wilson Yau Ki","family":"Chan","sequence":"first","affiliation":[{"name":"Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine Hong Kong Children's Hospital  Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison 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