Clin Transplant Res.  2024 Jun;38(2):145-149. 10.4285/ctr.24.0002.

Successful kidney transplantation from a live donor with immune thrombocytopenia: a case report

• Yang HH
• Ho CC
• Lee CL
• Wu YF
• Chen YC

• KMID: 2557608
• DOI: http://doi.org/10.4285/ctr.24.0002

Abstract

Organ transplantation from donors with immune thrombocytopenia (ITP), a condition involving the autoantibody-mediated destruction of platelets, is a topic of debate due to the potential for transplantation-mediated autoimmune thrombocytopenia (TMAT), a rare but potentially fatal complication. Previous reports have described transplants from deceased liver donors with ITP who had very low platelet counts and disease largely refractory to treatment. Here, we present the first case of living kidney transplantation from a donor with ITP who underwent preoperative treatment, with concurrent splenectomy performed to reduce the long-term risk of spontaneous hemorrhage. To ensure the safety of the procedure, we monitored perioperative rotational thromboelastometry parameters and platelet counts, leading to the normalization of the donor’s platelet levels. The recipient experienced an uneventful recovery of renal function without perioperative bleeding or the development of TMAT. Our report suggests that kidney transplantation from a donor with well-managed ITP is safe, and such a condition should not be considered a contraindication for donation.

Keyword

Immune thrombocytopenia; Organ donation; Transplantation-mediated thrombocytopenia; Case report

Figure

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  Fig. 1 Serial platelet counts of the recipient following kidney transplantation. The recipient’s serial platelet counts were monitored daily following transplantation to promptly identify any potential for transplant-mediated autoimmune thrombocytopenia. Throughout the early postoperative period, the platelet counts remained within the normal range. OP, operation; POD, postoperative day.

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