Thrombotic microangiopathy associated with combined sirolimus and tacrolimus immunosuppression after intestinal transplantation.

PARAMESH AS; GROSSKREUTZ C; FLORMAN SS; GONDOLESI GE; SHARMA S; KAUFMAN SS; FISHBEIN TM

TRANSPLANTATION

LIPPINCOTT WILLIAMS & WILKINS

Lugar: Philadelphia; Año: 2004 vol. 77 p. 129 - 131

0041-1337

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.