肝移植受者他克莫司相关性肥厚型心肌病。
Tacrolimus related hypertrophic cardiomyopathy in liver transplant recipients.
机构信息
Shiraz Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Arch Iran Med. 2010 Mar;13(2):116-9.
BACKGROUND
Recently there are a number of reports on the cardiotoxicity of tacrolimus in post-transplant patients. There is no protocol for cardiovascular evaluation in these patients. This study was performed to evaluate the cardiotoxicity of tacrolimus in liver transplant recipients.
METHODS
We evaluated 63 post-liver transplant patients who received tacrolimus. They were evaluated for cardiovascular complications by physical examination, electrocardiographic and echocardiographic examinations within three and six months following liver transplantation. Serum tacrolimus levels were checked by ELISA. For comparison, we selected 50 post-liver transplant patients who received no tacrolimus and evaluated them for cardiovascular function identically.
RESULTS
Among 63 patients, 42 were male (66.7%) and 21 were female (33.3%); 70% of the patients were adults, and 19 (30%) were within the pediatric age group. The cardiovascular examinations, electrocardiogram and echocardiography of all patients three months post-transplantation were normal except for two children who developed tacrolimus related cardiac complications. Both had high serum tacrolimus levels. No adults developed cardiovascular complications. In the control group, the results of the cardiovascular evaluations were normal in all cases.
CONCLUSION
The cardiovascular toxicity of tacrolimus, such as hypertrophic cardiomyopathy, may be observed in pediatric patients. Therefore, we recommend routine regular cardiovascular evaluation of children after liver transplantation.
背景
最近有许多关于肝移植患者使用他克莫司后出现心脏毒性的报告。这些患者没有心血管评估的方案。本研究旨在评估肝移植受者使用他克莫司后的心脏毒性。
方法
我们评估了 63 例接受他克莫司治疗的肝移植后患者。他们在肝移植后 3 至 6 个月内通过体格检查、心电图和超声心动图检查评估心血管并发症。通过 ELISA 检查血清他克莫司水平。为了进行比较，我们选择了 50 例接受无他克莫司治疗的肝移植后患者，并对他们进行了相同的心血管功能评估。
结果
在 63 例患者中，男性 42 例（66.7%），女性 21 例（33.3%）；70%的患者为成年人，19 例（30%）为儿童。所有患者在移植后 3 个月的心血管检查、心电图和超声心动图均正常，除了 2 例发生与他克莫司相关的心脏并发症的儿童。他们的血清他克莫司水平均较高。没有成年人发生心血管并发症。在对照组中，所有患者的心血管评估结果均正常。
结论
在儿科患者中可能观察到他克莫司的心血管毒性，如肥厚型心肌病。因此，我们建议肝移植后儿童常规定期进行心血管评估。
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