Renal transplantation and idiopathic thrombocytopenic purpura: two case reports

Kidney transplantation has rarely been performed in patients with immune thrombocytopenic purpura (ITP). We present two cases of kidney recipients from unrelated donors in women who had prior chronic refractory ITP. Their immunosuppression included induction therapy with antithymocyte globulin (ATG) and maintenance treatment with cyclosporine and prednisone. Kidney transplantations were safely performed without any complication. The platelet count of our patients increased gradually after the surgery, and maintenance with cyclosporine, mycophenolate mofetil, and prednisolone allowed graft function and satisfactory hemostasis. During the 3- and 8-year follow-up periods in our recipients, graft function was well maintained. We speculated that immunosuppressive agents, especially cyclosporine, may result in safe platelet counts and resolve thrombocytopenia in cases with refractory ITP prior to transplantation.