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

Czubkowski P, Pawlowska J, Jankowska I, Teisseyre M, Kaminska D, Markiewicz M, Ryzko 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.