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Updated: Aug 29, 2026
Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
Thrombotic microangiopathy associated with combined sirolimus and tacrolimus immunosuppression after intestinal
Anil S Paramesh1, Celia Grosskreutz, Sander S Florman
1The Recanati/Miller Transplantation Institute, Division of Intestinal Transplantation, The Mount Sinai School of Medicine, New York, New York, USA.
Abstract:
Calcineurin inhibitor-induced thrombotic microangiopathy (TMA) has been described in up to 14% of solid-organ transplant recipients. Sirolimus has recently been described in two reports in association with TMA. Sirolimus is known to potentiate cyclosporine-induced nephrotoxicity, but such effect has not been shown with tacrolimus. We report two intestinal transplant patients who developed TMA while on a tacrolimus and sirolimus immunosuppressive regimen. This syndrome appeared soon after institution of or increase in sirolimus dosage and improved only after this medication was discontinued.
