Sirolimus-associated hepatotoxicity in the kidney graft recipient

Transpl Int. 2005 Nov;18(11):1302-3. doi: 10.1111/j.1432-2277.2005.00210.x.


The aim of our paper was to describe hepatotoxicity of sirolimus (SRL) in a kidney graft recipient. We report the case of a 30-year-old male after kidney transplantation, treated with steroids, cyclosporin A and SRL, with steroid-resistant acute rejection in anamnesis. At 16th month after transplantation, elevation of serum aminotransfereases was observed. After exclusion of common reasons of this condition, liver biopsy was performed. Nonspecific changes were observed, with probability of drug-induced injury. SRL was changed to mycophenolate mofetil, which was followed by quick normalization of serum aminotransferase levels. Hepatoxicity is a rare complication of SRL therapy and may be connected with some diagnostic and/or therapeutic problems. Conversion to another immunosuppressant seems to be an appropriate procedure in this condition.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Chemical and Drug Induced Liver Injury / etiology*
  • Cyclosporine / administration & dosage
  • Drug Therapy, Combination
  • Graft Rejection / drug therapy*
  • Graft Rejection / pathology
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation*
  • Male
  • Mycophenolic Acid / administration & dosage
  • Mycophenolic Acid / analogs & derivatives
  • Sirolimus / administration & dosage
  • Sirolimus / adverse effects*
  • Steroids / administration & dosage


  • Immunosuppressive Agents
  • Steroids
  • Cyclosporine
  • Mycophenolic Acid
  • Sirolimus