Abstract: Thrombotic microangiopathy (TMA) is a lethal complication of renal transplantation that severely affects the long-term survival of the renal transplant recipient and the transplanted kidney. Transplant renal thrombotic microangiopathy can be divided into de novo TMA and recurrent atypical haemolytic uremic syndrome (aHUS). De novo TMA is more common and has a worse prognosis than recurrent aHUS. At this stage, the clinical manifestations of TMA in transplanted kidneys are varied and specific tests are lacking. Therefore, the diagnosis of TMA in transplanted kidneys relies heavily on kidney tissue biopsy. No precise individualised treatment protocols with proven efficacy have been studied. This paper reviews the recent research progress in the pathogenesis and treatment of TMA in transplanted kidneys, providing new ideas for the accurate diagnosis and effective treatment of TMA in transplanted kidneys in the future.

Key words: kidney transplantation, thrombotic microangiopathy, eculizumab, complications