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Tacrolimus-induced thrombotic microangiopathy (TMA) after heart and lung transplantation successfully treated with eculizumab.
Transpl Immunol
December 2024
Pulmonary, Critical Care and Cardiothoracic Surgery, Northwell Health Systems, 300 Community Dr, Manhasset, NY 11030, United States of America.
Introduction: Tacrolimus-induced thrombotic microangiopathy (TMA) causing acute kidney injury (AKI) without systemic features is a rare entity, particularly after non-renal solid organ transplantation.
Case Report: We describe the case of a patient with AKI after combined heart and lung transplantation. Renal biopsy revealed acute thrombotic microangiopathy which ultimately prompted initiation of eculizumab, a monoclonal antibody targeted against complement C5, with subsequent recovery in renal function.
Beyond Immunosuppression: The Intricate Relationship Between Tacrolimus and Microangiopathy.
Cureus
November 2023
Internal Medicine, Penn State Health Hershey Medical Center, Hershey, USA.
Tacrolimus, widely known as Prograf, has become the preferred immunosuppressant for preventing graft rejection in solid organ transplant recipients, particularly in steroid-sparing regimens. Its efficacy and reduced risk of acute and chronic rejection compared to cyclosporine have made it the preferred treatment option for transplant patients. However, tacrolimus has drawbacks as it is associated with adverse effects, such as renal tubular necrosis, kidney failure, hypertension, metabolic acidosis, and new-onset diabetes mellitus.
View Article and Find Full Text PDFTacrolimus-induced thrombotic microangiopathy post-liver transplantation for cryptogenic acute liver failure in an infant.
Ann Hematol
March 2023
Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, 85004, USA.
Tacrolimus-Induced Thrombotic Microangiopathy After Orthotopic Heart Transplant: A Case Report.
Cureus
June 2022
Cardiovascular Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, USA.
Tacrolimus (FK 506) is a calcineurin inhibitor and is commonly used as an immunosuppressant after a solid organ transplant. One of the serious adverse effects of tacrolimus is thrombotic microangiopathy (TMA) which has a high mortality rate. TMA leads to vascular thrombosis, eventually leading to ischemia of end organs.
View Article and Find Full Text PDFTacrolimus Induced Thrombotic Microangiopathy (TMA) Presenting as Acute Macular Neuroretinopathy.
Ocul Immunol Inflamm
January 2023
Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
This report highlights the association of tacrolimus use with acute macular neuroretinopathy (AMN). A 27-year-old woman, a known case of diffuse proliferative membranous glomerulonephritis, developed abnormal body movements, loss of consciousness, and blurring of vision in the left eye, after 3 months of starting tacrolimus. Blood investigations revealed anemia, thrombocytopenia, raised urea and creatinine levels, and raised LDH levels.
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