Which Thrombotic Microangiopathy Came First? A Differential of Delayed Kidney Graft Function (KIDNEY WEEK 2026) - Oct 2, 2026 - Abstract #SA-PO1197; Pres time: Oct 24, 2026; 10:00 AM - 12:00 PM; Location: Exhibit Hall A, Convention Center; "Case Description The patient was a 60-year-old Pakistani male with kidney failure due to hypertension, CAD with stent placement, chronic combined heart failure, and a history of spontaneous left renal hematoma development (Wunderlich syndrome) eight years prior requiring embolization who underwent a deceased donor kidney transplant with basiliximab induction...He received anti-thymocyte globulin and plasmapheresis, and as the patient's DGF persisted he was also given eculizumab for possible atypical HUS...Initially tacrolimus was changed to sirolimus, and later to cyclosporine to improve post-operative wound healing...Discussion This case shows how post-transplant TMA reduces diagnostic certainty and emphasizes patient involved decision-making. Our case had a mixed presentation of tacrolimus usage vs Banff IIa mixed TCMR by histology, in addition to possible atypical HUS given his prior episode of Wunderlich syndrome"
Antibody-mediated Rejection • Atypical Hemolytic Uremic Syndrome • Cardiovascular • Complement-mediated Rare Disorders • Congestive Heart Failure • Heart Failure • Hematological Disorders • Hypertension • Nephrology • Thrombocytopenia
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Robert L. Jameson; Carl P. Walther; Muhammad Suleman Ajmal; Bhamidipati V.R. Murthy
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