Successful Treatment of Transplant Associated Thrombotic Microangiopathy (TA-TMA) with Low Dose Defibrotide

  • Santhosh Kumar Devadas
  • Manoj Toshniwal
  • Bhausaheb Bagal
  • Navin KhattryEmail author
Short Communication


Transplant associated microangiopathy (TA-TMA) is a potentially serious complication of stem cell transplantation. Though stopping calcineurin/mTOR inhibitor is the first step in managing TA-TMA, this is not always adequate. The pathophysiology of TA-TMA is different from microangiopathy seen in other settings. Many drugs have been used in TA-TMA with modest responses. Defibrotide has been explored in TA-TMA in the past with good results. However, its availability is erratic and cost of therapy very high. Hence its routine use in low middle income country (LMIC) is financially demanding. We report the use of low dose defibrotide safely and successfully in this case series. This is pertinent more to LMIC’s and warrants prospective evaluation.


Defibrotide Allogeneic Transplant Microangiopathy 


Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2017

Authors and Affiliations

  • Santhosh Kumar Devadas
    • 1
  • Manoj Toshniwal
    • 1
  • Bhausaheb Bagal
    • 1
  • Navin Khattry
    • 1
    • 2
    Email author
  1. 1.Bone Marrow Transplant Unit, ACTRECTata Memorial CentreNavi-MumbaiIndia
  2. 2.Department of Medical Oncology, Room No. 247, Paymaster Shodhika, ACTRECTata Memorial CentreNavi-MumbaiIndia

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