title: Reversible sinusoidal obstruction syndrome associated with tacrolimus following liver transplantation.
abstract: Sinusoidal obstruction syndrome (SOS), previously known as hepatic veno-occlusive disease, is a rare disorder in solid organ transplant patients, and is an uncommon complication after liver transplantation. Severe SOS with hepatic failure causes considerable mortality. Tacrolimus has been reported to be an offending agent, which potentially plays a role in the pathophysiological process of SOS. SOS due to tacrolimus has been reported in lung and pancreatic transplantations, but has never been described in a liver transplant recipient. Herein, we present a case of SOS after liver transplantation, which was possibly related to tacrolimus. A 27-year-old man developed typical symptoms of SOS with painful hepatomegaly, ascites and jaundice after liver transplantation, which regressed following withdrawal of tacrolimus. By excluding other possible predisposing factors, we concluded that tacrolimus was the most likely cause of SOS.
authors.affiliation: Tian Shen, Xiao-Wen Feng, Lei Geng, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Shen
authors.affiliation: Tian Shen, Xiao-Wen Feng, Lei Geng, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Feng
authors.affiliation: Tian Shen, Xiao-Wen Feng, Lei Geng, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Geng
authors.affiliation: Tian Shen, Xiao-Wen Feng, Lei Geng, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Zheng
mesh_terms: D000328:Adult; D001706:Biopsy; D016572:Cyclosporine / Q000008:administration & dosage; D057915:Drug Substitution; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus
keywords: Liver transplantation; Predisposing factor; Sinusoidal obstruction syndrome; Tacrolimus; Veno-occlusive disease