Thrombotic microangiopathy (TMA) is a common complication occurring post-hematopoietic stem cell transplantation (HSCT). It causes microvascular thrombosis, leading to thrombocytopenia, ischemic tissue damage, and microangiopathic hemolytic anemia

HSCT-TMA is an under-recognized condition associated with substantial morbidity and mortality, with greater awareness of the condition required to improve outcomes

The complement system appears to play a key role in the pathogenesis of TMA following HSCT

Key panels of risk factors and simple diagnostic and monitoring criteria exist to help identify, diagnose, and monitor patients with HSCT-TMA, and are summarized in this manuscript

Prompt management of HSCT-TMA is associated with improved outcomes and complement-targeted therapies also show utility in this population, although further randomized clinical trials and research into long-term outcomes are needed