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FK 506 associated disorders in liver transplantation
H Nazer1, E al-Sabban, H Harfi
1Department of Paediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Journal of Gastroenterology and Hepatology
|May 1, 1992
Summary
Post-transplant lymphoproliferative disorder (PTLD) and renal complications occurred in a child receiving FK 506 after a liver transplant. These adverse events resolved after discontinuing the immunosuppressant FK 506.
Area of Science:
- Immunology
- Transplantation Medicine
- Pediatric Oncology
Background:
- Organ transplantation necessitates immunosuppressive therapy to prevent rejection.
- Post-transplant lymphoproliferative disorder (PTLD) is a rare but serious complication of immunosuppression.
- FK 506 (tacrolimus) is a novel immunosuppressant used in organ transplant recipients.
Observation:
- A 20-month-old child developed PTLD while on FK 506 therapy post-liver transplantation.
- The child also experienced progressive renal complications and challenges with viral antibody interpretation.
- Clinical manifestations included lymphadenopathy, hepatosplenomegaly, fever, neutropenia, and thrombocytopenia.
Findings:
- The observed PTLD and associated symptoms were linked to FK 506 immunosuppression.
- Progressive renal toxicity was also noted during FK 506 treatment.
- Discontinuation of FK 506 led to the reversal of PTLD and renal complications.
Implications:
- This case highlights the potential association between FK 506 and PTLD, a complication previously recognized with cyclosporine.
- Clinicians should be vigilant for PTLD and renal toxicity in patients receiving FK 506.
- Reversible adverse effects suggest careful monitoring and potential modification of immunosuppressive strategies in pediatric transplant patients.