Sirolimus rescue for tacrolimus-associated post-transplant autoimmune hemolytic anemia.
Autoimmune hemolytic anemia (AIHA) has been reported to occur after renal transplantation, and typically does so in the first few weeks post-transplant. We report on a 3-yr-old child who developed cold AIHA nearly 1 yr after an ABO identical, living donor renal transplant from his mother. Numerous transfusions, pulse steroids, repeat plasma exchange treatments, and IVIG were unsuccessful. Nearly 3 wk into his illness, tacrolimus was changed to cyclosporine, and then to sirolimus, and resulted in a prompt response. He currently has a normal renal function and a normal hemoglobin level on sirolimus monotherapy.
Valentini
Rudolph P
RP
Division of Nephrology, The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI 48201-2196, USA. rvalen@med.wayne.edu
Imam
Abubakr
A
Warrier
Indira
I
Ellis
Demetrius
D
Ritchey
A Kim
AK
Ravindranath
Yaddanapudi
Y
Shapiro
Ron
R
Moritz
Michael L
ML