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Sirolimus rescue for tacrolimus‐associated post‐transplant autoimmune hemolytic anemia
Author(s) -
Valentini Rudolph P.,
Imam Abubakr,
Warrier Indira,
Ellis Demetrius,
Ritchey A. Kim,
Ravindranath Yaddanapudi,
Shapiro Ron,
Moritz Michael L.
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.1399-3046.2005.00460.x
Subject(s) - medicine , tacrolimus , sirolimus , autoimmune hemolytic anemia , rescue therapy , hemolytic anemia , immunology , transplantation , antibody
Autoimmune hemolytic anemia (AIHA) has been reported to occur after renal transplantation, and typically does so in the first few weeks post‐transplant. We report on a 3‐yr‐old child who developed cold AIHA nearly 1 yr after an ABO identical, living donor renal transplant from his mother. Numerous transfusions, pulse steroids, repeat plasma exchange treatments, and IVIG were unsuccessful. Nearly 3 wk into his illness, tacrolimus was changed to cyclosporine, and then to sirolimus, and resulted in a prompt response. He currently has a normal renal function and a normal hemoglobin level on sirolimus monotherapy.