Thrombotic microangiopathy (TMA) is a rare but very serious condition. It is characterized by widespread microthrombi formation in multiple organs (in its severe and disseminated form) or localized microthrombi in the kidney (in its limited form). TMA is usually characterized by thrombocytopenia, microangiopathic hemolytic anemia (MAHA), and multiple organ injury and dysfunction.
Early detection and accurate diagnosis are essential to implement appropriate therapies, and improve patients’ prognosis and survival. Delay in diagnosis could result in late implementation of appropriate therapies, and this could result in permanent and irreversible organ damage. Left untreated TMA is associated with very high level of morbidity and mortality. TMA presentation could be highly variable making the diagnosis even more difficult. Once the diagnosis of TMA is established, defining the underlying cause is even more challenging due to frequent overlap between the common causes of TMA.
We have a unique multidisciplinary approach to the management of this very rare disease. A TMA team was established at Boston University Medical Center with the primary objective of improving patients care and outcome. Our Team works in close collaboration with the ARC on Thrombosis.
A primary goal of the team is to provide excellent patient care. The TMA team is multidisciplinary involving: nephrologists, hematologists, the director of apheresis, pediatric hematologist and pharmacist. They are always available to manage any patient with suspected TMA. Special protocols and algorithm have been created by the team to help guiding the provider in making an accurate diagnosis of any TMA case.
Another goal of the TMA team is educational. We are actively spreading awareness of this rare disease between our providers at BMC, and also regionally and nationally by organizing lectures and seminars as well as mini-symposia.
A third goal of the TMA team is to advance basic and clinical research related to TMA. We are active in clinical trials addressing the efficacy of newer agents for the treatment of complement mediated HUS a special form of TMA. Our scientists are also trying to understand some underlying pathological mechanisms that could be contributing to TMA.
- Lebanese University, MD
- Lebanese University, BS
- Published on 5/9/2019
Belghasem ME, A'amar O, Roth D, Walker J, Arinze N, Richards SM, Francis JM, Salant DJ, Chitalia VC, Bigio IJ. Towards minimally-invasive, quantitative assessment of chronic kidney disease using optical spectroscopy. Sci Rep. 2019 May 09; 9(1):7168. PMID: 31073168.
- Published on 3/1/2019
Arinze NV, Gregory A, Francis JM, Farber A, Chitalia VC. Unique aspects of peripheral artery disease in patients with chronic kidney disease. Vasc Med. 2019 Mar 01; 1358863X18824654. PMID: 30823859.
- Published on 2/18/2019
Cohen-Bucay A, Gordon CE, Francis JM. Non-immunological complications following kidney transplantation. F1000Res. 2019; 8. PMID: 30828430.
- Published on 11/29/2018
Gordon CE, Balk EM, Francis JM. Summary of the 2018 Kidney Disease Improving Global Outcomes (KDIGO) Guideline on hepatitis C in chronic kidney disease. Semin Dial. 2019 03; 32(2):187-195. PMID: 30496617.
- Published on 9/19/2018
Gabardi S, Pavlakis M, Tan C, Francis J, Cardarelli F, Asch W, Bodziak K, Chobanian M, Gilligan H, Gohh R, Kung SC, Inker L, Martin S, Rodig N, Rossi A, Chandraker A. New England BK consortium: Regional survey of BK screening and management protocols in comparison to published consensus guidelines. Transpl Infect Dis. 2018 Dec; 20(6):e12985. PMID: 30175491.
- Published on 7/17/2018
Kumaradevan S, Lee SY, Richards S, Lyle C, Zhao Q, Tapan U, Jiangliu Y, Ghumman S, Walker J, Belghasem M, Arinze N, Kuhnen A, Weinberg J, Francis J, Hartshorn K, Kolachalama VB, Cifuentes D, Rahimi N, Chitalia VC. c-Cbl Expression Correlates with Human Colorectal Cancer Survival and Its Wnt/ß-Catenin Suppressor Function Is Regulated by Tyr371 Phosphorylation. Am J Pathol. 2018 Aug; 188(8):1921-1933. PMID: 30029779.
- Published on 4/1/2018
Ding Y, Francis J, Gautam A, Pelletier L, Sanchorawala V, Quillen K. Durable renal response after combination of bortezomib, corticosteroids, rituximab, and plasmapheresis for late antibody-mediated renal transplant rejection?. Clin Nephrol. 2018 Apr; 89(4):252-259. PMID: 29208204.
- Published on 4/1/2018
Reddy YNV, Nunes D, Chitalia V, Gordon CE, Francis JM. Hepatitis C virus infection in kidney transplantation-changing paradigms with novel agents. Hemodial Int. 2018 04; 22 Suppl 1:S53-S60. PMID: 29694721.
- Published on 4/1/2018
Cohen-Bucay A, Francis JM, Gordon CE. Timing of hepatitis C virus infection treatment in kidney transplant candidates. Hemodial Int. 2018 04; 22 Suppl 1:S61-S70. PMID: 29694723.
- Published on 1/17/2018
Kolachalama VB, Shashar M, Alousi F, Shivanna S, Rijal K, Belghasem ME, Walker J, Matsuura S, Chang GH, Gibson CM, Dember LM, Francis JM, Ravid K, Chitalia VC. Uremic Solute-Aryl Hydrocarbon Receptor-Tissue Factor Axis Associates with Thrombosis after Vascular Injury in Humans. J Am Soc Nephrol. 2018 Mar; 29(3):1063-1072. PMID: 29343519.
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