[Management of transplant-associated thrombotic microangiopathy].

The clinical features of transplant-associated thrombotic microangiopathy (TA-TMA) include microangiopathic hemolytic anemia, consumptive thrombocytopenia, and organ dysfunction caused by thrombi in microvessels. The pathogenesis of TA-TMA is based on vascular endothelial insults caused by various factors, including chemotherapy and total-body irradiation used for transplant pre-conditioning, calcineurin inhibitors, cytokines release associated with infection, and complement factors. The incidence of TA-TMA is approximately 15-30% among allogeneic transplant patients, and the mortality rate reaches 100% in severe cases with multi-organ dysfunction. This review describes the current understanding of the pathogenesis, diagnostic criteria, and treatment strategies of this potentially lethal transplant-associated complication.