Survival analysis of transplant-associated thrombotic microangiopathy under different diagnostic criteria and the efficacy of plasma exchange

20 June 2023 : Original article

Yifan Xu

^12ABCDEF, Yan Wei^12BF, Lijun Wang^2BC, Ning Lu^2BD, Yongli Wu^2BD, Liping Dou^2AF, Daihong Liu

^2AF, Meng Li^2ADEF*, Chunji Gao^2ADEFG

DOI: 10.12659/AOT.939890

Ann Transplant 2023; 28:e939890

Background Material and Methods Results Discussion Conclusions References

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Table 2 Univariate analysis of the efficacy of PE for TA-TMA.

Variable	Response to PE		P value
Variable	NR (n=12)	CR/PR (n=9)	P value
	139.5 (41–591)	67.0 (22–179)

ABO compatibility	8 (66.7%)	7 (77.8%)	0.659
HLA matched	4 (33.3%)	2 (22.2%)	0.659
Sex matched	8 (66.7%)	6 (66.7%)	>0.99
III–IV aGVHD prior to TA-TMA, n (%)	8 (66.7%)	3 (33.3%)	0.198
EBV/CMV infections preceding TA-TMA, n (%)	10 (83.3%)	7 (77.8%)	>0.99

Elevated total bilirubin	8 (66.7%)	1 (11.1%)
GI bleeding	9 (75.0%)	6 (66.7%)	>0.99
Proteinuria	6 (50.0%)	7 (77.8%)
Hypoproteinemia	10 (83.3%)	6 (66.7%)	0.611
Hypertension	4 (33.3%)	4 (44.4%)
Renal or neurological dysfunction	8 (66.7%)	1 (11.1%)
Bacterial infection	12 (100.0%)	8 (88.9%)	0.429

Hb (g/L), mean	59.5±9.2	76.2±12.3
PLT (×10/L), median	11.5 (3–32)	35 (7–165)	0.577
LDH (U/L), median	536.8 (196.6–1790.4)	314.9 (244.9–665.0)	0.286
Schistocytes (%), median	1.5 (0.0–4.0)	1.5 (0.0–2.6)	0.583
TBIL (μmol/L), median	40.4 (4.7–329.0)	9.6 (4.7–34.7)
Initial volume of PE (L), median	2.0 (1.2–4.0)	2.4 (1.9–3.5)	0.924
Cumulative volume of PE (L), median	9.0 (1.7–25.2)	15.3 (6.2–51.2)	0.127
Number of PE sessions, median	3.5 (1–11)	6 (2–25)	0.054
Data are presented as the mean±SD, median (range, minimum-maximum), or n (%). Significant P values are in bold type. HLA – human leukocyte antigen; TBI – total body irradiation; aGVHD – acute graft-versus-host disease; CMV – cytomegalovirus; EBV – Epstein-Barr virus; LDH – lactate dehydrogenase; TBIL – total bilirubin; PE – plasma exchange; GI – gastrointestinal; Hb – hemoglobin; PLT – platelet.

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