Tacrolimus related hypertrophic cardiomyopathy in liver transplant recipients.
BACKGROUND
Recently there are a number of reports on the cardiotoxicity of tacrolimus in post-transplant patients. There is no protocol for cardiovascular evaluation in these patients. This study was performed to evaluate the cardiotoxicity of tacrolimus in liver transplant recipients.


METHODS
We evaluated 63 post-liver transplant patients who received tacrolimus. They were evaluated for cardiovascular complications by physical examination, electrocardiographic and echocardiographic examinations within three and six months following liver transplantation. Serum tacrolimus levels were checked by ELISA. For comparison, we selected 50 post-liver transplant patients who received no tacrolimus and evaluated them for cardiovascular function identically.


RESULTS
Among 63 patients, 42 were male (66.7%) and 21 were female (33.3%); 70% of the patients were adults, and 19 (30%) were within the pediatric age group. The cardiovascular examinations, electrocardiogram and echocardiography of all patients three months post-transplantation were normal except for two children who developed tacrolimus related cardiac complications. Both had high serum tacrolimus levels. No adults developed cardiovascular complications. In the control group, the results of the cardiovascular evaluations were normal in all cases.


CONCLUSIONS
The cardiovascular toxicity of tacrolimus, such as hypertrophic cardiomyopathy, may be observed in pediatric patients. Therefore, we recommend routine regular cardiovascular evaluation of children after liver transplantation.
Dehghani
Seyed Mohsen
SM
Shiraz Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. dehghanism@sums.ac.ir
Haghighat
Mahmood
M
Imanieh
Mohammad Hadi
MH
Zahmatkeshan
Mozhgan
M
Borzooei
Mohammad
M
Amoozegar
Hamid
H
Zamirian
Mahmood
M
Gholami
Siavash
S
Bahador
Ali
A
Nikeghbalian
Saman
S
Salahi
Heshmatollah
H
Malek-Hosseini
Seyed Ali
SA
D000293:Adolescent; D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000139:chemically induced* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
D007166:Immunosuppressive Agents; D016559:Tacrolimus