title: Successful sirolimus rescue in tacrolimus-induced thrombotic microangiopathy after living-related liver transplantation.
abstract: TMA is a rare complication of tacrolimus. Disruption of endothelial cells, platelet aggregation, and intravascular mechanical fragmentation of red cells are core mechanisms of injury; however, exact pathways of toxicity are not clear. The clinical presentation may vary but TMA is a potentially life-threatening condition usually demanding aggressive treatment. We present the case of TMA in a child after living-related liver transplantation (LRLTx) on tacrolimus-based immunosuppressive regiment successfully converted to sirolimus.
authors: Department of Gastroenterology, The Children's Memorial Health Institute, Warsaw, Poland. piotr.czubkowski@mp.pl
authors: Piotr
authors: P
authors: Czubkowski
authors: Joanna
authors: J
authors: Pawłowska
authors: Irena
authors: I
authors: Jankowska
authors: Mikołaj
authors: M
authors: Teisseyre
authors: Diana
authors: D
authors: Kamińska
authors: Małgorzata
authors: M
authors: Markiewicz
authors: Józef
authors: J
authors: Ryżko
mesh_terms: D000743:Anemia, Hemolytic / Q000150:complications / Q000628:therapy; D001706:Biopsy; D004912:Erythrocytes / Q000187:drug effects; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D017093:Liver Failure / Q000150:complications* / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D010974:Platelet Aggregation / Q000187:drug effects; D020123:Sirolimus / Q000627:therapeutic use*; D016559:Tacrolimus / Q000009:adverse effects* / Q000633:toxicity; D057049:Thrombotic Microangiopathies / Q000139:chemically induced* / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus