Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant

Sirolimus is a mammalian target of rapamycin (mTOR) inhibitor often used in clinical conjunction with calcineurin inhibitors (CNIs) or mycophenolate mofetil to prevent solid organ transplant rejection. While nephrotoxicity is a well-known side effect of CNIs, renal injury because of mTOR inhibitors...

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Main Authors: Tabeer Rana, Shivani Shah, Lydia Du, Sheena Mago, Tavankit Singh, Mark Bunker
Format: Article
Language:English
Published: American College of Physicians 2024-06-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.0960
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author Tabeer Rana
Shivani Shah
Lydia Du
Sheena Mago
Tavankit Singh
Mark Bunker
author_facet Tabeer Rana
Shivani Shah
Lydia Du
Sheena Mago
Tavankit Singh
Mark Bunker
author_sort Tabeer Rana
collection DOAJ
description Sirolimus is a mammalian target of rapamycin (mTOR) inhibitor often used in clinical conjunction with calcineurin inhibitors (CNIs) or mycophenolate mofetil to prevent solid organ transplant rejection. While nephrotoxicity is a well-known side effect of CNIs, renal injury because of mTOR inhibitors is exceedingly rare and limited to case reports, primarily in the setting of renal transplant and post-hematopoietic stem cell transplant. This case demonstrates a rare occurrence of sirolimus-induced thrombotic microangiopathy after orthotopic liver transplant.
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publisher American College of Physicians
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-295b79698aee474690f41ef697289cdf2025-08-20T02:11:45ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-06-013610.7326/aimcc.2023.0960Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver TransplantTabeer Rana0Shivani Shah1Lydia Du2Sheena Mago3Tavankit Singh4Mark Bunker51Department of Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania1Department of Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania2Department of Pathology, Allegheny Health Network, Pittsburgh, Pennsylvania3Department of Gastroenterology and Hepatology, Allegheny Health Network, Pittsburgh, Pennsylvania3Department of Gastroenterology and Hepatology, Allegheny Health Network, Pittsburgh, Pennsylvania2Department of Pathology, Allegheny Health Network, Pittsburgh, PennsylvaniaSirolimus is a mammalian target of rapamycin (mTOR) inhibitor often used in clinical conjunction with calcineurin inhibitors (CNIs) or mycophenolate mofetil to prevent solid organ transplant rejection. While nephrotoxicity is a well-known side effect of CNIs, renal injury because of mTOR inhibitors is exceedingly rare and limited to case reports, primarily in the setting of renal transplant and post-hematopoietic stem cell transplant. This case demonstrates a rare occurrence of sirolimus-induced thrombotic microangiopathy after orthotopic liver transplant.https://www.acpjournals.org/doi/10.7326/aimcc.2023.0960
spellingShingle Tabeer Rana
Shivani Shah
Lydia Du
Sheena Mago
Tavankit Singh
Mark Bunker
Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant
Annals of Internal Medicine: Clinical Cases
title Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant
title_full Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant
title_fullStr Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant
title_full_unstemmed Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant
title_short Thrombotic Microangiopathy Secondary to Sirolimus Monotherapy in Orthotopic Liver Transplant
title_sort thrombotic microangiopathy secondary to sirolimus monotherapy in orthotopic liver transplant
url https://www.acpjournals.org/doi/10.7326/aimcc.2023.0960
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AT sheenamago thromboticmicroangiopathysecondarytosirolimusmonotherapyinorthotopiclivertransplant
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