Reactions 1704, p352 - 2 Jun 2018 Post-liver transplantation ascites: case report A 49-year-old man developed post-liver transplantation ascites following treatment with tacrolimus [route and duration of treatment to reaction onset not stated]. The man, who had chronic hepatic failure secondary to hepatitis B and cirrhosis, underwent liver transplantation. Subsequently, he started receiving immunosuppressive therapy consisting of tacrolimus 4mg daily, concurrently with prednisone and mycophenolate mofetil. The tacrolimus trough blood concentration was maintained at 7-8.7 ng/mL. On 10th postoperative day, he developed ascites. Subsequent ultrasonographic evaluation revealed massive ascites. The Colour Doppler ultrasonography revealed normal finding. The ascites were found to be resistant to the treatment. To alleviate the symptoms, weekly therapeutic aspiration of the ascitic fluid was required. Subsequent analyses of ascitic fluid as well as liver biopsy findings were found to be unremarkable. Consequently, he was diagnosed with post-liver transplantation ascites considered to be secondary to the tacrolimus treatment. The man’s treatment with tacrolimus was discontinued and was switched to sirolimus. Ascites had minimal effect towards the treatment and the weekly therapeutic aspiration of the ascitic fluid was necessary to alleviate the symptoms. Biochemical, cytological and microbiological analyses of the ascitic fluid had unremarkable results. A subsequent liver biopsy showed no significant abnormality in the two separate pathological reviews. Within 10 days of tacrolimus discontinuation, ascites resolved. He remained asymptomatic in his subsequent follow-up visits for more than two years. Author comment: "In conclusion, in the event of post- liver transplantation ascites, tacrolimus consumption, as a probable cause, must always be kept in mind after ruling out other etiologies." Hosseini M, et al. Tacrolimus-induced ascites after liver transplant. International Journal of Organ Transplantation Medicine 9: 102-104, No. 2, 2018 - Iran 803323078 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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