Kidney Week

Abstract: SA-PO820

Thrombotic Microangiopathy Multidisciplinary Team Assessment: Single-Center Case Series

Session Information

• C3G, TMA, MGRS, Amyloidosis, and More
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Nguyen, Matthew Duy Thanh Luyen, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Matthew Duy Thanh Luyen Nguyen

• Patel, Samir Dinesh, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Samir Dinesh Patel, MD, PhD

• Al Ammary, Fawaz, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Fawaz Al Ammary, MD, PhD

• Tran, Minh-Ha, University of California Irvine - Department of Medicine - Division of Transfusion Medicine, Irvine, California, United States

Minh-Ha Tran, DO

• Ciurea, Stefan Octavian, University of California Irvine - Department of Medicine - Division of Hematology & Oncology, Irvine, California, United States

Stefan Octavian Ciurea, MD, PhD, MBA

• Desai, Sheetal, University of California Irvine - Department of Medicine - Division of Rheumatology, Irvine, California, United States

Sheetal Desai, MD

• Amin, Alpesh, University of California Irvine - Department of Medicine, Irvine, California, United States

Alpesh Amin, MD

• Zhao, Hongyu, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Hongyu Zhao

• Vadpey, Omid, University of California Irvine - Department of Medicine, Irvine, California, United States

Omid Vadpey, MD

• Truong, Tai, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Tai Truong, MD

• Abdelmalek, Antoinette, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Antoinette Abdelmalek

• Perkins, Jordan, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Jordan Perkins, MS

• Ahdoot, Rebecca S., University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Rebecca S. Ahdoot

• Malik, Fatima T., University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Fatima T. Malik, MD

• Ferrey, Antoney Joseph, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Antoney Joseph Ferrey, MD, FASN

• Reddy, Uttam Gummadi, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Uttam Gummadi Reddy, MD

• Tantisattamo, Ekamol, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Ekamol Tantisattamo, MD, MPH, FASN

• Chang, Yongen, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Yongen Chang, MD, PhD, FASN

• Lau, Wei Ling, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Wei Ling Lau, MD, FASN

• Khagi, Yulian, University of California Irvine - VA LBMC Department of Medicine - Division of Nephrology, Irvine, California, United States

Yulian Khagi, MD, MBA

• Lee, Lisa, University of California Irvine - Department of Medicine - Division of Hematology & Oncology, Irvine, California, United States

Lisa Lee, MD

• Pakbaz, Zahra, University of California Irvine - Department of Medicine - Division of Hematology & Oncology, Irvine, California, United States

Zahra Pakbaz, MD

• Hanna, Ramy Magdy, University of California Irvine Nephrology Hypertension & Kidney Transplantation, Orange, California, United States

Ramy Magdy Hanna, MD, FASN

Background

Thrombotic Microangiopathies (TMAs) include an etiological diverse group of phenotypically similar disorders. While individually rare, they are seen as an aggregate with regularity. Prior reports suggested the importance of approaching TMAs in a multidisciplinary fashion. We present the design, structure, evaluation workflow and data in the initial 3-year period of the established University of California Irvine (UCI) TMA team.

Methods

This is a single-center retrospective case series of 51 diverse patients demonstrating demographics, diagnoses, triggers, treatments applied, and outcomes for patients with the diagnosis of TMA

Results

Of the 51 patients, 31 were females with an age range between 18 and 83. Twenty patients were diagnosed with atypical hemolytic uremic syndrome (aHUS). Five patients were diagnosed with Hematopoetic Stem Cell Transplant associated TMA (HSCT-TMA), 2 patients had Thrombotic Thrombocytopenic purpura (TTP). Of the 20 aHUS patients, 13 were treated with anti-complement blockade and 7 were evaluated for potential future use of complement blockade. All patients treated with anti-complement blockade (100%) demonstrated a hematologic response, 75% (9 of 12) of patients requiring renal replacement therapy remain off dialysis after 6-18 months of treatment with anti-complement blockade. HSCT-TMA patients were treated with anti-complement blockade had a less positive response.

Conclusion

This case series highlights the importance of TMA multidisciplinary team to improve diagnosis and optimize outcomes of this rare condition. Future research is needed to assist efficacy and implementation of TMA-multidisciplinary care.