Hosseini M, Aliakbarian M, Akhavan-Rezayat K, Shadkam O, Milani S
Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Int J Organ Transplant Med. 2018;9(2):102-104. Epub 2018 May 1.
Massive post-transplantation ascites is a rare but serious condition following liver transplantation. Although, many etiologies are suggested as the cause of this complication, in some cases the definitive etiology remains unknown. Drug-induced post-transplantation ascites is one of the possible etiologies. In this study we present a case of ascites caused by tacrolimus in the post-liver transplantation period. A 49-year-old man with hepatitis B virus cirrhosis underwent liver transplantation and received tacrolimus, mycophenolate and prednisolone, as the immunosuppressive regimen. Progressive ascites developed after 10 days, in spite of a normal liver function. Various studies, including liver biopsy, were performed but we could not find any etiology for this complication. The tacrolimus was switched to rapamune. Ascites was completely disappeared and up to the last follow-up visit, the patient remained asymptomatic for more than two years. We concluded that after ruling out other etiologies, tacrolimus as a rare cause of post-transplantation ascites should be taken into account. The treatment is discontinuation of the drug.
肝移植后大量腹水是肝移植后一种罕见但严重的病症。尽管有许多病因被认为是这种并发症的原因，但在某些情况下，确切病因仍不明。药物性肝移植后腹水是可能的病因之一。在本研究中，我们报告一例肝移植术后由他克莫司引起腹水的病例。一名49岁的乙肝肝硬化男性接受了肝移植，并接受他克莫司、霉酚酸酯和泼尼松龙作为免疫抑制方案。尽管肝功能正常，但10天后出现进行性腹水。进行了包括肝活检在内的各种检查，但我们未能找到该并发症的任何病因。将他克莫司换为雷帕鸣。腹水完全消失，直至最后一次随访，患者在两年多时间里一直无症状。我们得出结论，在排除其他病因后，应考虑他克莫司作为肝移植后腹水的罕见病因。治疗方法是停用该药物。
