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Impairment of the blood‐brain barrier can result in tacrolimus‐induced reversible leucoencephalopathy following heart transplantation
Author(s) -
Kaczmarek Ingo,
Groetzner Jan,
Meiser Bruno,
Mueller Markus,
Landwehr Peter,
Ueberfuhr Peter,
Bruning Roland,
Reichart Bruno
Publication year - 2003
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2003.00071.x
Subject(s) - medicine , tacrolimus , heart transplantation , transplantation , blood–brain barrier , central nervous system disease , central nervous system
Fatal leucoencephalopathy is a rare calcineurin inhibitor‐related complication, especially in kidney and liver transplant recipients. The only means of clinical management reported so far is the discontinuation or reduction in the calcineurin inhibitor. We herein report a case of a 37‐yr‐old male who developed leucoencephalopathy 12 wk after heart transplantation and recovered after stabilization of metabolism and arterial blood pressure. The findings in this case support the hypothesis that tacrolimus‐associated neurotoxicity is severely increased by an impairment of the blood‐brain barrier. Withdrawal of tacrolimus was not necessary while other causes of endothelial injury were treated successfully.