Hepatic veno-occlusive disease due to tacrolimus in a single-lung transplant patient.
Hepatic veno-occlusive disease is defined as nonthrombotic fibrous obliterative endophlebitis of small centrilobular hepatic venules. Clinically, patients present with elevated liver enzymes and a triad of jaundice, hepatomegaly and ascites. Although reported as a complication of other solid organ and stem cell transplantation, there have been no reported cases to date of veno-occlusive disease following lung transplantation. The present authors report a case of veno-occlusive disease following single-lung transplantation in a patient on a triple-drug immunosuppressive regimen composed of tacrolimus, mycophenolate mofetil and prednisone. The diagnosis was established by transjugular liver biopsy and by discontinuing tacrolimus; there was clinical regression of symptoms and serological return to baseline.
Shah
S
S
Dept of Pulmonary, Allergy and Critical Care, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Budev
M
M
Blazey
H
H
Fairbanks
K
K
Mehta
A
A
D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016040:Lung Transplantation; D008875:Middle Aged; D016559:Tacrolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016559:Tacrolimus