Calcineurin inhibitor-related cholestasis complicating lung transplantation.

Oto, Takahiro; Okazaki, Mikio; Takata, Ken; Egi, Moritoki; Yamane, Masaomi; Toyooka, Shinichi; Sano, Yoshifumi; Snell, Gregory I et al. · Ann Thorac Surg · 2010

case_report · Level V

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Abstract

Hepatotoxicity, including cholestasis, is a rare but significant complication of treatment with calcineurin inhibitors. Timely life-saving therapy with revision of immunosuppression is mandatory. A 43-year-old woman with pulmonary hypertension was found to have severe cholestasis (serum bilirubin up to 35 mg/dL) after a living-donor lobar lung transplantation. Calcineurin-inhibitor cholestasis markedly improved after withdrawal of the calcineurin inhibitor, initiation of sirolimus, and interleukin-2 receptor blockade. Awareness of the diagnostic criteria of this rare posttransplant complication is important to initiate timely therapy.

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