Thrombotic microangiopathy (TMA) is a rare complication that may arise post-transplant in patients, however, incidence of TMA has increased in recent years with no clear reason. Speaking at the 2018 European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting in Lisbon, Portugal, Enric Carreras, MD, PhD, from the Hospital Clinic of Barcelona, Barcelona, Spain, analyses the current knowledge of TMA complications and discusses the potential of various therapeutic options available, including tacrolimus, rituximab and eculizumab.