Eculizumab and Renal Transplantation in a Patient with CAPS

To the Editor: The catastrophic antiphospholipid antibody syndrome (CAPS) is an episodic, diffuse thrombotic microangiopathy observed in less than 1% of patients with antiphospholipid antibodies and is characterized by vascular occlusions involving three or more organ systems.1 Typically preceded by triggering events, such as infection, trauma, or surgery, CAPS culminates in multiorgan system failure and is fatal in half of those in whom it develops. Although renal failure is common in CAPS survivors, kidney transplantation has traditionally not been considered in these patients because of the lack of specific therapies for preventing recurrent CAPS and a surgical risk of death . . .