Eligibility criteria
thrombotic microangiopathy, oncologic disease
THROMBOTIC MICROANGIOPATHY, SKIN AUTOIMMUNE DISEASE
Randomisation starts after day 93 following transplantation, because TTV load is not stable until month 4 and optimal TTV range has not been defined for the early post-transplant period. Patients on cyclosporine-, mTor inhibitor- or co-stimulation blocker-based immunosuppression cannot be included, because no sufficient data are available for optimal TTV load in these patients. An optimal TTV target is also not defined for patients with significant additional long-term immunosuppression or immune modulation (e.g. disease-modifying agents used in autoimmune disease or immune modulators used in oncologic disease) and thus such patients have to be excluded. Only patients with standard TAC target trough level are suitable for the trial and this is defined by the local centre. This might also exclude patients with, e.g. a lung transplantation, de novo DSA or thrombotic microangiopathy if the centre targets non-standard TAC trough levels in these circumstances. Patients with a TTV load always below 4.6 log10 c/mL during the screening phase cannot be randomised because TTV load might not reflect immunosuppression sufficiently in such setting.