Hepatic veno-occlusive disease resulting in tacrolimus toxicity after allogeneic hematopoietic stem cell transplantation.

Author: Seung Hwan SHIN ¹ ; Seung Ah YAHNG ; Jae Ho YOON ; Sung Eun LEE ; Byung Sik CHO ; Yoo Jin KIM
Author Information

1. Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea. yoojink@catholic.ac.kr
Publication Type:Case Report
Keywords: Tacrolimus; Veno-occlusive disease; Hematopoietic stem cell transplantation
MeSH: Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Hematopoietic Stem Cells; Hepatic Veno-Occlusive Disease; Humans; Liver; Tacrolimus
From:Blood Research 2013;48(1):55-57
CountryRepublic of Korea
Language:English
Abstract: Tacrolimus is a widely used immunosuppressive agent for the prophylaxis of graft-versus-host disease in allogeneic hematopoietic stem cell transplantation (HSCT). Since tacrolimus is primarily metabolized by the liver, hepatic dysfunction may affect its metabolism. Hepatic veno-occlusive disease (VOD) is an early complication of HSCT that results in hepatic dysfunction, suggesting that VOD may affect tacrolimus metabolism. We report a case of hepatic VOD accompanied by a sustained high blood trough level of tacrolimus despite its discontinuation. The findings of this case suggest that the elimination of tacrolimus can be markedly delayed in patients with hepatic VOD, and that the clinician should carefully modulate the drug dosage for these patients.