Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation

Ueno, Takehisa; Toyama, Chiyoshi; Deguchi, Koichi; Masahata, Kazunori; Nomura, Motonari; Watanabe, Miho; Kamiyama, Masafumi; Tazuke, Yuko; Bessho, Kazuhiko; Okuyama, Hiroomi

doi:https://doi.org/10.1016/j.transproceed.2021.12.036

Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation

Ueno, Takehisa; Toyama, Chiyoshi; Deguchi, Koichi et al.

Transplantation Proceedings, 2022, 54(2), 468-471

Number of Access:1,217（2025-07-22 22:23 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/96474

Link to primary information

File	Format	Terms of use	Size	Views	Date.Available
TransplantProc_54_2_468	pdf	None	115 KB	18	2024.06.28
TransplantProc_54_2_468_figure	pdf	None	266 KB	18	2024.06.28
TransplantProc_54_2_468_table	pdf	None	148 KB	19	2024.06.28

Creative Commons : Attribution - NonCommercial - NoDerivatives

Item Information

Output File Export EndNote Basic Export Mendeley

Title	Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation
Creator	NRID 1000010456957 1000010456957 ORCID 0000-0002-4639-8814 0000-0002-4639-8814 researchmap permalink ueno-pedsurg ueno-pedsurg Scopus Author ID 21743992300 21743992300 CreatorName Ueno, Takehisa
	NRID 1000010839369 1000010839369 CreatorName Toyama, Chiyoshi
	NRID 1000000747082 1000000747082 researchmap permalink deguchi_koichi deguchi_koichi Scopus Author ID 57139781700 57139781700 CreatorName Deguchi, Koichi
	NRID 1000040588381 1000040588381 CreatorName Masahata, Kazunori
	NRID 1000040546909 1000040546909 researchmap permalink moto_pedsurg moto_pedsurg Scopus Author ID 35208741700 35208741700 ORCID 0009-0004-0959-7461 0009-0004-0959-7461 CreatorName Nomura, Motonari
	NRID 1000040791728 1000040791728 researchmap permalink miho miho Scopus Author ID 56282966800 56282966800 ORCID 0000-0001-6691-0611 0000-0001-6691-0611 CreatorName Watanabe, Miho
	NRID 1000020403074 1000020403074 researchmap permalink kamiyamapedsurg kamiyamapedsurg Scopus Author ID 55559187300 55559187300 CreatorName Kamiyama, Masafumi
	NRID 1000010397698 1000010397698 researchmap permalink yukotazuke-osaka yukotazuke-osaka Scopus Author ID 7006109798 7006109798 ORCID 0000-0002-8335-0414 0000-0002-8335-0414 CreatorName Tazuke, Yuko
	NRID 1000080423169 1000080423169 researchmap permalink KazuBe KazuBe CreatorName Bessho, Kazuhiko
	NRID 1000030252670 1000030252670 researchmap permalink okuyamahiroomi okuyamahiroomi Scopus Author ID 35496082300 35496082300 ORCID 0000-0002-1347-282X 0000-0002-1347-282X CreatorName Okuyama, Hiroomi
Description	Ueno T., Toyama C., Deguchi K., et al. Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation. Transplantation Proceedings 54, 468 (2022); https://doi.org/10.1016/j.transproceed.2021.12.036.
Abstract	Background: Tacrolimus-related neurotoxicity is a serious complication. Posterior reversible encephalopathy syndrome, which is severe neurotoxicity after pediatric living donor liver transplantation (LDLT), is a medication-induced complication related to calcineurin inhibitors. The purpose of this study was to evaluate the long-term outcome of tacrolimus-related neurotoxicity after pediatric LDLT. Methods: Pediatric patients who underwent LDLT between 2007 and 2020 at our institution and developed neurologic symptoms with tacrolimus were included in the study. Tacrolimus-related encephalopathy was defined as encephalopathy that resolved after tacrolimus was discontinued. All patients received tacrolimus and a steroid for immunosuppression starting just after LDLT. Results: During the study period, 128 patients underwent LDLT. All patients received tacrolimus and a steroid. Six patients (5%) developed tacrolimus-related encephalopathy. The median age at transplant was 1.6 years. The original diseases were biliary atresia (n = 5) and progressive familial intrahepatic cholangiopathy type 2 (n = 1). Patients developed encephalopathy at a median of 9 days after LDLT. All patients recovered with conversion to cyclosporine. Posterior reversible encephalopathy syndrome was confirmed by magnetic resonance imaging in 3 patients. The mean tacrolimus level at encephalopathy was 11 ng/dL (range, 5.6-14.6 ng/dL). White blood cell count elevation was observed in all patients. One patient died of pancreatitis. Surviving patients (n = 5) were followed for a median of 9 years. All patients resumed tacrolimus a median of 8 months from onset. No neurologic complications were observed after resuming tacrolimus. Conclusion: We observed tacrolimus-induced encephalopathy in 5% of patients after pediatric LDLT. Patients can resume tacrolimus safely without further neurologic symptoms.
Publisher	Elsevier Inc.
Source Title	Transplantation Proceedings
Volume (Issue)	54(2)
Page	468-471
Date of Issued	2022-03-01
Language	English
Handle URL	https://hdl.handle.net/11094/96474
PISSN	00411345
eISSN	18732623
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1016/j.transproceed.2021.12.036
Access Rights	open access
CopyRight	© 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Transplantation Proceedings. 2022, 54(2), p. 468-471
DC.title	Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation
DC.creator	Ueno, Takehisa
	Toyama, Chiyoshi
	Deguchi, Koichi
	Masahata, Kazunori
	Nomura, Motonari
	Watanabe, Miho
	Kamiyama, Masafumi
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
DC.publisher	Elsevier Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2022-03-01
DC.identifier	https://doi.org/10.1016/j.transproceed.2021.12.036
DC.description	Ueno T., Toyama C., Deguchi K., et al. Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation. Transplantation Proceedings 54, 468 (2022); https://doi.org/10.1016/j.transproceed.2021.12.036.
DCTERMS.abstract	Background: Tacrolimus-related neurotoxicity is a serious complication. Posterior reversible encephalopathy syndrome, which is severe neurotoxicity after pediatric living donor liver transplantation (LDLT), is a medication-induced complication related to calcineurin inhibitors. The purpose of this study was to evaluate the long-term outcome of tacrolimus-related neurotoxicity after pediatric LDLT. Methods: Pediatric patients who underwent LDLT between 2007 and 2020 at our institution and developed neurologic symptoms with tacrolimus were included in the study. Tacrolimus-related encephalopathy was defined as encephalopathy that resolved after tacrolimus was discontinued. All patients received tacrolimus and a steroid for immunosuppression starting just after LDLT. Results: During the study period, 128 patients underwent LDLT. All patients received tacrolimus and a steroid. Six patients (5%) developed tacrolimus-related encephalopathy. The median age at transplant was 1.6 years. The original diseases were biliary atresia (n = 5) and progressive familial intrahepatic cholangiopathy type 2 (n = 1). Patients developed encephalopathy at a median of 9 days after LDLT. All patients recovered with conversion to cyclosporine. Posterior reversible encephalopathy syndrome was confirmed by magnetic resonance imaging in 3 patients. The mean tacrolimus level at encephalopathy was 11 ng/dL (range, 5.6-14.6 ng/dL). White blood cell count elevation was observed in all patients. One patient died of pancreatitis. Surviving patients (n = 5) were followed for a median of 9 years. All patients resumed tacrolimus a median of 8 months from onset. No neurologic complications were observed after resuming tacrolimus. Conclusion: We observed tacrolimus-induced encephalopathy in 5% of patients after pediatric LDLT. Patients can resume tacrolimus safely without further neurologic symptoms.
DC.rights	© 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
DC.format	96474
citation_title	Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation
citation_author	Ueno, Takehisa
	Toyama, Chiyoshi
	Deguchi, Koichi
	Masahata, Kazunori
	Nomura, Motonari
	Watanabe, Miho
	Kamiyama, Masafumi
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
citation_publisher	Elsevier Inc.
citation_language	English
citation_date	2022-03-01
citation_journal_title	Transplantation Proceedings
citation_volume	54
citation_issue	2
citation_firstpage	468
citation_lastpage	471
citation_doi	https://doi.org/10.1016/j.transproceed.2021.12.036
citation_public_url	https://hdl.handle.net/11094/96474

Long-Term Outcome After Tacrolimus-Related Neurotoxicity in Pediatric Living Donor Liver Transplantation

Link to primary information

Item Information

Show details