Successful outcome of tacrolimus-associated thrombotic microangiopathy in renal transplant recipient with plasmapharesis

We report a case of a renal transplant recipient treated with tacrolimus, who developed Thrombotic microangiopathy (TMA). TMA is a well-documented, severe and acute adverse effect of tacrolimus that occurs after solid-organ transplant. He was managed with complete withdrawal of tacrolimus, increasing the dose of mycophenolate mofetil and plasmapharesis with fresh-frozen plasma as replacement fluid. This was resulted in normalization of renal functions. The remission was sustained during follow-up of 12 months.