8 patients with thrombotic microangiopathy were treated with a new antilfcrombotic agent, defibrotide. This drug displays considerable fibrinolytic and antithrombotic activity, and induces generation and release of a prostacyclin-like substance from vascular tissue. At admission all patients presented severe renal involvement and coagulation abnormäÄies. Neurological manifestations were present in 6. Defibrotide admiu&tration was followed by recovery of renal function in 6, disappearance of neurological Symptoms and coagulation abnormalities in all p9l!ajits. The use of defibrotide was not associated with side effects. On the basis of the results obtained in these patients, we suggest that defibrotide might be considered as a valuable drug in the management of patients with thrombotic microangiopathy.