title: Sirolimus rescue for tacrolimus-associated post-transplant autoimmune hemolytic anemia.
abstract: 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.
authors: 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
authors: Rudolph P
authors: RP
authors: Valentini
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authors: Imam
authors: Indira
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authors: Ritchey
authors: Yaddanapudi
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authors: Ravindranath
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authors: Moritz