ArticleJACC. Case reports2025
Tacrolimus-Induced Thrombotic Microangiopathy in Orthotopic Heart Transplant Patients: A Case Series and Review of Literature.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Vascularization of Human iPSC-Derived Kidney Organoids Using Perfusion Culture, Pre-Vascularized Collagen Scaffolds, and Decellularized Extracellular Matrix.Advanced healthcare materials · 2026Article
- Belatacept as an Emerging Option in Immunosuppression-Induced Thrombotic Microangiopathy After Heart Transplantation.JACC. Case reports · 2025Article
- Reply: Belatacept as an Emerging Option in Immunosuppression-Induced Thrombotic Microangiopathy After Heart Transplantation.JACC. Case reports · 2025Article
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8 authors.
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Abstract
backgroundThrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage from microvascular injury. Tacrolimus-induced TMA, although rare in heart transplant recipients, presents diagnostic and management challenges. CASE SUMMARY: We present 3 cases of postorthotopic heart transplant patients on tacrolimus who developed TMA, presenting with new-onset anemia, elevated lactate dehydrogenase, low haptoglobin, and schistocytes. All patients had elevated tacrolimus levels and responded to discontinuation, transitioning to alternative immunosuppressants like sirolimus or everolimus. Kidney function and hematologic abnormalities improved with therapy adjustments. DISCUSSION: Tacrolimus-induced TMA, although infrequent in heart transplant patients, requires a high index of suspicion. Diagnosis can be difficult due to complex clinical histories, complex medication regimen, and variable time of onset. Early identification and tacrolimus discontinuation are essential for favorable outcomes. TAKE-HOME MESSAGES: Tacrolimus-induced TMA is a rare but serious complication in heart transplant patients. Timely diagnosis and tacrolimus cessation are crucial for optimal outcomes.
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