Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient
The immunosuppressant tacrolimus has a narrow therapeutic window, necessitating therapeutic drug monitoring to maintain efficacy and minimise toxicity. There are very few reports examining the impact of impaired biliary excretion on tacrolimus blood levels or toxicity. We report the case of a 26-yea...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2017/9096435 |
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| _version_ | 1832549536839499776 |
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| author | Samuel Chan Michael T. Burke David W. Johnson Ross S. Francis David W. Mudge |
| author_facet | Samuel Chan Michael T. Burke David W. Johnson Ross S. Francis David W. Mudge |
| author_sort | Samuel Chan |
| collection | DOAJ |
| description | The immunosuppressant tacrolimus has a narrow therapeutic window, necessitating therapeutic drug monitoring to maintain efficacy and minimise toxicity. There are very few reports examining the impact of impaired biliary excretion on tacrolimus blood levels or toxicity. We report the case of a 26-year-old combined liver and kidney transplant recipient, who developed acute biliary obstruction leading to tacrolimus toxicity with very high blood tacrolimus levels. Despite a careful evaluation, no alternative cause was found for her acute kidney injury, and her kidney function returned to previous baseline within several days following treatment of the biliary obstruction and temporary withdrawal of tacrolimus. |
| format | Article |
| id | doaj-art-bb4211dfe5444dd4afd99e184109b6f3 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-bb4211dfe5444dd4afd99e184109b6f32025-02-03T06:11:08ZengWileyCase Reports in Transplantation2090-69432090-69512017-01-01201710.1155/2017/90964359096435Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant RecipientSamuel Chan0Michael T. Burke1David W. Johnson2Ross S. Francis3David W. Mudge4Queensland Renal Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, AustraliaQueensland Renal Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, AustraliaQueensland Renal Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, AustraliaQueensland Renal Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, AustraliaQueensland Renal Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, AustraliaThe immunosuppressant tacrolimus has a narrow therapeutic window, necessitating therapeutic drug monitoring to maintain efficacy and minimise toxicity. There are very few reports examining the impact of impaired biliary excretion on tacrolimus blood levels or toxicity. We report the case of a 26-year-old combined liver and kidney transplant recipient, who developed acute biliary obstruction leading to tacrolimus toxicity with very high blood tacrolimus levels. Despite a careful evaluation, no alternative cause was found for her acute kidney injury, and her kidney function returned to previous baseline within several days following treatment of the biliary obstruction and temporary withdrawal of tacrolimus.http://dx.doi.org/10.1155/2017/9096435 |
| spellingShingle | Samuel Chan Michael T. Burke David W. Johnson Ross S. Francis David W. Mudge Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient Case Reports in Transplantation |
| title | Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient |
| title_full | Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient |
| title_fullStr | Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient |
| title_full_unstemmed | Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient |
| title_short | Tacrolimus Toxicity due to Biliary Obstruction in a Combined Kidney and Liver Transplant Recipient |
| title_sort | tacrolimus toxicity due to biliary obstruction in a combined kidney and liver transplant recipient |
| url | http://dx.doi.org/10.1155/2017/9096435 |
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