Tacrolimus-Associated Leukoencephalopathy Following a Living Donor Kidney Transplant for Autosomal Recessive Alport Syndrome: A Case Report.

A 20-year-old male patient diagnosed with chronic renal failure owing to autosomal recessive Alport syndrome underwent kidney transplant, with his mother as the donor. After transplant, the patient's renal function was enhanced; however, owing to preoperative nonadherence, he required sedation and mechanical ventilation. Sedation and mechanical ventilation were discontinued on postoperative day 5. The next day, the patient experienced impaired consciousness. On day 7, magnetic resonance imaging of the head revealed posterior reversible encephalopathy syndrome. Tacrolimus was immediately discontinued, and steroid pulse therapy was initiated. The patient gradually gained consciousness and reached preoperative levels by day 10. Autosomal recessive Alport syndrome, a rare form of Alport syndrome, constitutes 15% of all cases. This report documents a case of tacrolimus-associated posterior reversible encephalopathy syndrome after living donor kidney transplant.