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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Immune thrombocytopenic purpura (ITP) is a clinical syndrome in which a decreased number of circulating platelets (thrombocytopenia). The combination of ITP and chronic kidney injury is uncommon. We present two cases of kidney recipients from unrelated donors in women who had prior chronic refractory ITP. In adults with the chronic form of ITP, women are affected more frequently than men, such as our patients. Intravenous infusion of antithymocyte globulin (ATG) was done before their operation as induction therapy and the maintenance immunosuppressive regimen included cyclosporine, mycophenolate mofetil/azathioprine and prednisone. Kidney transplantations were safely performed without any complication such as hemorrhage during and after the operation. The platelet count of our patients increased gradually after the surgery and complete remission was achieved. During the 3 and 8 -year follow up period in our recipients, the graft function was well maintained. Renal transplantation in a patient with ITP is suggested with a well-designed approach to avoid potential complications. We speculate that immunosuppressive agents, especially cyclosporine, may result in safe platelet counts and resolve thrombocytopenia in our cases with refractory ITP prior transplantation. Cyclosporine therapy after kidney transplantation seems to be a reasonable treatment in cases of ITP that do not respond to standard managements.

Volume : 6
Issue : 4
Pages : 208

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Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran