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Tacrolimus‐induced cholestatic syndrome following pediatric liver transplantation and steroid‐resistant graft rejection
Author(s) -
Ganschow Rainer,
Albani Johannes,
Grabhorn Enke,
Richter Andrea,
Burdelski Martin
Publication year - 2006
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2005.00413.x
Subject(s) - tacrolimus , medicine , liver transplantation , immunosuppression , prednisolone , transplantation , gastroenterology , cholestasis , ciclosporin , methylprednisolone , surgery
Several factors may contribute to post‐transplant cholestatic complications after liver transplantation. These include ischemic reperfusion injury, hypoperfusion, bile duct strictures, and hepatotoxic drugs. Up to now, there have been no publications on tacrolimus cholestatic toxicity in clinical transplantation when the drug was used in therapeutic doses. We describe six pediatric liver graft recipients in whom cholestatic complications developed under a tacrolimus‐based immunosuppression following liver transplantation and all of them suffered from previous steroid‐resistant graft rejection. The overall incidence of cholestatic syndrome was 5.4% in children receiving tacrolimus. The immunosuppression was switched back to cyclosporine and prednisolone in all six patients resulting in completely resolved clinical signs and laboratory findings. We conclude from our observations that a cholestatic syndrome following pediatric liver transplantation may be caused by tacrolimus therapy following steroid‐resistant graft rejection, even if given in therapeutic doses.