Posterior reversible encephalopathy syndrome and heart failure tacrolimus-induced after liver transplantation: A case report

World J Clin Cases. 2020 Jul 6;8(13):2870-2875. doi: 10.12998/wjcc.v8.i13.2870.

Abstract

Background: Patients undergoing liver transplantation can develop posterior reversible encephalopathy syndrome (PRES) and acute heart failure (HF) in the post-operative period. But PRES with HF caused by tacrolimus has rarely been described.

Case summar: A 40-year-old female patient who had a normal preoperative cardiac and neural evaluation developed PRES with acute heart failure tacrolimus-induced after liver transplantation. The challenges associated with both diagnosis and management in the setting of a newly implanted graft are discussed.

Conclusion: Tacrolimus can induce neurotoxicity and then cardiac toxicity. Magnetic resonance imaging, echocardiography, and increased brain natriuretic peptide may be predictive of post-operative PRES with acute heart failure. Further investigations are necessary to verify this finding.

Keywords: Cardiac toxicity; Case report; Liver transplantation; Neurologic complications; Posterior reversible encephalopathy syndrome; Tacrolimus.

Publication types

  • Case Reports