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Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of

Jamie Bloom¹, Micaela Langille Collins², Mia P Belovsky³

¹Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA.

Journal of Cardiothoracic and Vascular Anesthesia

|April 29, 2023

Abstract:

TACROLIMUS, a mainstay of immunosuppression after orthotopic heart transplantation (OHT), is associated with a broad range of side effects. Vasoconstriction caused by tacrolimus has been proposed as a mechanism underlying common side effects such as hypertension and renal injury. Neurologic side effects attributed to tacrolimus include headaches, posterior reversible encephalopathy syndrome (PRES), or reversible cerebral vasospasm syndrome (RCVS). Six case reports have been published describing RCVS in the setting of tacrolimus administration after OHT. The authors report a case of perfusion-dependent focal neurologic deficits attributed to tacrolimus-induced RCVS in an OHT recipient.

Keywords:

orthotopic heart transplant posterior reversible encephalopathy syndrome reversible cerebral vasospasm syndrome reversible posterior leukoencephalopathy syndrome tacrolimus

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