NDLI: Rescue therapy with sirolimus in a renal transplant recipient with tacrolimus-induced hepatotoxicity

Content Provider	Taylor & Francis Online
Author	Kes, Petar Hudolin, Tvrtko Basic-Jukic, Nikolina Mesar, Ines
Abstract	Calcineurin inhibitors at elevated serum concentrations frequently cause mild elevation of the liver chemistries. Although rare, severe hepatotoxicity is their serious complication. A 54-year-old man with end-stage renal disease due to chronic glomerulonephritis without biopsy received a renal allograft from the deceased donor. Eleven days after transplantation severe liver injury (AST up to 421 IU/L, ALT 1242 IU/L, and GGT 212 IU/L) with the serum bilirubin within the normal range was recorded. Tacrolimus trough level was 5.5 ng/mL. Liver ultrasound and color-Doppler of the portal system were normal. Liver failure completely resolved after withdrawal of the calcineurin inhibitor and switch to sirolimus. After 9 months of follow-up our patient has excellent graft and liver function. Awareness of the possible association of tacrolimus use with hepatotoxicity is important to timely discontinuation of the causative agent, and to introduce sirolimus as the rescue therapy.
Starting Page	1434
Ending Page	1435
Page Count	2
File Format	PDF HTM / HTML
DOI	10.3109/0886022X.2013.828356
Journal	Renal Failure
Volume Number	35
Issue Number	10
Language	English
Publisher	Taylor & Francis
Publisher Date	2013-10-15
Access Restriction	Open
Subject Keyword	Hepatotoxicity Renal transplantation Sirolimus Tacrolimus
Content Type	Text

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Rescue therapy with sirolimus in a renal transplant recipient with tacrolimus-induced hepatotoxicity