Perfusion-Dependent Focal Neurologic Deficits in a Critically

J. Cardiothorac. Vasc. Anesth. · Aug 2023

Case Reports

Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome?

TACROLIMUS, a mainstay of immunosuppression after orthotopic heart transplantation (OHT), is associated with a broad range of side effects. Vasoconstriction caused by tacrolimus has been proposed as a mechanism underlying common side effects such as hypertension and renal injury. ⋯ Six case reports have been published describing RCVS in the setting of tacrolimus administration after OHT. The authors report a case of perfusion-dependent focal neurologic deficits attributed to tacrolimus-induced RCVS in an OHT recipient.

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- Jamie Bloom, Micaela Langille Collins, Mia P Belovsky, Eric Feduska, Patrick Schofield, Ron Leong, John G Augoustides, Ilya Lembrikov, Alexander Kogan, Jonathan Frogel, Karuna Puttur Rajkumar, Megan H Hicks, and Rohesh J Fernando.
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA.
- J. Cardiothorac. Vasc. Anesth. 2023 Aug 1; 37 (8): 148714941487-1494.
AbstractTACROLIMUS, a mainstay of immunosuppression after orthotopic heart transplantation (OHT), is associated with a broad range of side effects. Vasoconstriction caused by tacrolimus has been proposed as a mechanism underlying common side effects such as hypertension and renal injury. Neurologic side effects attributed to tacrolimus include headaches, posterior reversible encephalopathy syndrome (PRES), or reversible cerebral vasospasm syndrome (RCVS). Six case reports have been published describing RCVS in the setting of tacrolimus administration after OHT. The authors report a case of perfusion-dependent focal neurologic deficits attributed to tacrolimus-induced RCVS in an OHT recipient.Copyright © 2023 Elsevier Inc. All rights reserved.

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Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome?

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