August 16, 2025

Kidney transplantation in congenital thrombotic thrombocytopaenic purpura: using recombinant ADAMTS13 to balance relapse and rejection.

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Discussion

Case report shows ADAMTS13 helps manage TMA and rejection in a kidney transplant recipient with cTTP, suggesting a promising approach.

ADAMTS13 treatment halted thrombotic microangiopathy (TMA) and prevented future episodes in a kidney transplant recipient with cTTP.
The patient had repeated T-cell-mediated rejection and systemic TMA, which did not respond adequately to the initial immunosuppressive regimen.
Adjustments to the immunosuppressive regimen and increased plasma exchange provided only temporary relief from TMA symptoms.
This case highlights the potential benefits of using ADAMTS13 over traditional plasma exchange in this rare condition.

Zethof et al. (2025) studied this question.

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