Turska-Kmieć Anna, Jankowska Irena, Pawłowska Joanna, Kaliciński Piotr, Kawalec Wanda, Tomyn Małgorzata, Markiewicz Małgorzata, Teisseyre Joanna, Czubkowski Piotr, Rekawek Joanna, Socha Jerzy
Department of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland.
Pediatr Transplant. 2007 May;11(3):319-23. doi: 10.1111/j.1399-3046.2006.00633.x.
Tacrolimus (Tac)-related hypertrophic cardiomyopathy (HCM) has been reported to be an unusual but serious complication affecting pediatric patients after solid organ transplantation. Herein, we present a case of young liver transplant recipient with Tac-induced HCM, treated by discontinuation of Tac followed by conversion to rapamycin (Rap). Our case report points out the potential but rather low risk of HCM during Tac immunosuppression in pediatric liver transplants and demonstrates that replacement of calcineurin inhibitors with mammalian target of Rap (mTOR) inhibitors may be an efficacious therapeutic tool to effect regression of established cardiac hypertrophy.
据报道，他克莫司（Tac）相关的肥厚型心肌病（HCM）是实体器官移植后影响儿科患者的一种罕见但严重的并发症。在此，我们报告一例年轻的肝移植受者，其患有他克莫司诱发的HCM，通过停用他克莫司并随后转换为雷帕霉素（Rap）进行治疗。我们的病例报告指出了小儿肝移植中他克莫司免疫抑制期间发生HCM的潜在但相当低的风险，并表明用雷帕霉素哺乳动物靶点（mTOR）抑制剂替代钙调神经磷酸酶抑制剂可能是使已形成的心脏肥大消退的一种有效治疗手段。
