Successful sirolimus rescue in tacrolimus‐induced thrombotic microangiopathy after living‐related liver transplantation

Czubkowski P, Pawłowska J, Jankowska I, Teisseyre M, Kamińska D, Markiewicz M, Ryżko J. Successful sirolimus rescue in tacrolimus‐induced thrombotic microangiopathy after living‐related liver transplantation. Pediatr Transplantation 2011: 00: 000–000. © 2011 John Wiley & Sons A/S. Abstract:  TMA is a rare complication of tacrolimus. Disruption of endothelial cells, platelet aggregation, and intravascular mechanical fragmentation of red cells are core mechanisms of injury; however, exact pathways of toxicity are not clear. The clinical presentation may vary but TMA is a potentially life‐threatening condition usually demanding aggressive treatment. We present the case of TMA in a child after living‐related liver transplantation (LRLTx) on tacrolimus‐based immunosuppressive regiment successfully converted to sirolimus.