Successful conversion to belatacept after thrombotic microangiopathy in kidney transplant patients

Abstract Thrombotic microangiopathy ( TMA ) is a severe complication of kidney transplantation. TMA may occur de novo or as recurrent disease post‐transplant. De novo disease is usually associated with immunosuppressive drugs or can be seen as a part of endothelial damage that accompanies antibody‐mediated rejection. Treatment for de novo TMA is limited to plasma exchange and change in immunosuppression. We report two cases of de novo TMA post‐transplant that were successfully treated by converting to belatacept for maintenance immunosuppression.