title: Hepatic veno-occlusive disease due to tacrolimus in a single-lung transplant patient.
abstract: 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.
authors.affiliation: Dept of Pulmonary, Allergy and Critical Care, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.forename: M
authors.initials: M
authors.lastname: Budev
authors.forename: H
authors.initials: H
authors.lastname: Blazey
authors.forename: K
authors.initials: K
authors.lastname: Fairbanks
authors.forename: A
authors.initials: A
authors.lastname: Mehta
mesh_terms: 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*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus