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Article: Tacrolimus (FK 506)-induced thrombotic thrombocytopenic purpura after ABO mismatched second liver transplantation: Salvage with plasmapheresis and prostacyclin

TitleTacrolimus (FK 506)-induced thrombotic thrombocytopenic purpura after ABO mismatched second liver transplantation: Salvage with plasmapheresis and prostacyclin
Authors
KeywordsTacrolimus
TTP
Issue Date2000
Citation
Haematologica, 2000, v. 85 n. 6, p. 659-662 How to Cite?
AbstractWe report the course of thrombotic thrombocytopenic purpura (TTP) in a patient receiving tacrolimus (FK506) immunosuppression for an ABO mismatched second liver graft. A Chinese woman with fulminant hepatitis-B reactivation failed a living-related orthotopic liver transplantation (OLT) due to portal vein thrombosis. An ABO mismatched cadaveric OLT (group A to O) was performed, with peri-operative plasmapheresis to reduce anti-A hemagglutinin titers. On day 30, she developed fever, hemolysis, thrombocytopenia and neurologic dulling. Prominent microangiopathic features in peripheral blood film, and characteristic brain lesions on magnetic resonance imaging confirmed TTP. She responded initially to intensive plasmapheresis with cryosupernatant replacement, and withdrawal of FK506. An attempted reintroduction of FK506 for threatened rejection led to TTP exacerbation. This was controlled with prolonged plasmapheresis and a ten-day infusion of prostacyclin. Immunosuppression was changed to mycophenolate mofetil. By day 53, the peripheral film and lactate dehydrogenase level had returned to baseline and plasmapheresis was stopped. (C) 2000, Ferrata Storti Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/172773
ISSN
2023 Impact Factor: 8.2
2023 SCImago Journal Rankings: 2.490
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAu, WYen_US
dc.contributor.authorLie, AKWen_US
dc.contributor.authorLam, CCKen_US
dc.contributor.authorFan, STen_US
dc.contributor.authorLiu, CLen_US
dc.contributor.authorYoung, Ken_US
dc.contributor.authorLo, CMen_US
dc.date.accessioned2012-10-30T06:24:51Z-
dc.date.available2012-10-30T06:24:51Z-
dc.date.issued2000en_US
dc.identifier.citationHaematologica, 2000, v. 85 n. 6, p. 659-662en_US
dc.identifier.issn0390-6078en_US
dc.identifier.urihttp://hdl.handle.net/10722/172773-
dc.description.abstractWe report the course of thrombotic thrombocytopenic purpura (TTP) in a patient receiving tacrolimus (FK506) immunosuppression for an ABO mismatched second liver graft. A Chinese woman with fulminant hepatitis-B reactivation failed a living-related orthotopic liver transplantation (OLT) due to portal vein thrombosis. An ABO mismatched cadaveric OLT (group A to O) was performed, with peri-operative plasmapheresis to reduce anti-A hemagglutinin titers. On day 30, she developed fever, hemolysis, thrombocytopenia and neurologic dulling. Prominent microangiopathic features in peripheral blood film, and characteristic brain lesions on magnetic resonance imaging confirmed TTP. She responded initially to intensive plasmapheresis with cryosupernatant replacement, and withdrawal of FK506. An attempted reintroduction of FK506 for threatened rejection led to TTP exacerbation. This was controlled with prolonged plasmapheresis and a ten-day infusion of prostacyclin. Immunosuppression was changed to mycophenolate mofetil. By day 53, the peripheral film and lactate dehydrogenase level had returned to baseline and plasmapheresis was stopped. (C) 2000, Ferrata Storti Foundation.en_US
dc.languageengen_US
dc.relation.ispartofHaematologicaen_US
dc.subjectTacrolimus-
dc.subjectTTP-
dc.subject.meshAbo Blood-Group System - Adverse Effectsen_US
dc.subject.meshAdulten_US
dc.subject.meshBlood Grouping And Crossmatchingen_US
dc.subject.meshEpoprostenol - Administration & Dosageen_US
dc.subject.meshFemaleen_US
dc.subject.meshHepatitis B - Surgery - Therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Transplantation - Methodsen_US
dc.subject.meshPlasmapheresisen_US
dc.subject.meshPurpura, Thrombotic Thrombocytopenic - Blood - Chemically Induceden_US
dc.subject.meshSalvage Therapyen_US
dc.subject.meshTacrolimus - Administration & Dosage - Adverse Effectsen_US
dc.titleTacrolimus (FK 506)-induced thrombotic thrombocytopenic purpura after ABO mismatched second liver transplantation: Salvage with plasmapheresis and prostacyclinen_US
dc.typeArticleen_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.identifier.authorityLo, CM=rp00412en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid10870125-
dc.identifier.scopuseid_2-s2.0-0033947462en_US
dc.identifier.hkuros48705-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033947462&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume85en_US
dc.identifier.issue6en_US
dc.identifier.spage659en_US
dc.identifier.epage662en_US
dc.identifier.isiWOS:000088000800016-
dc.publisher.placeItalyen_US
dc.identifier.scopusauthoridAu, WY=7202383089en_US
dc.identifier.scopusauthoridLie, AKW=24284842400en_US
dc.identifier.scopusauthoridLam, CCK=16947291300en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US
dc.identifier.scopusauthoridLiu, CL=7409789712en_US
dc.identifier.scopusauthoridYoung, K=7402600967en_US
dc.identifier.scopusauthoridLo, CM=7401771672en_US
dc.identifier.issnl0390-6078-

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