Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2015; 21(20): 6422-6426
Published online May 28, 2015. doi: 10.3748/wjg.v21.i20.6422
Reversible sinusoidal obstruction syndrome associated with tacrolimus following liver transplantation
Tian Shen, Xiao-Wen Feng, Lei Geng, Shu-Sen Zheng
Tian Shen, Xiao-Wen Feng, Lei Geng, Shu-Sen Zheng, Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Shen T treated the patient and drafted the paper; Feng XW performed pathological analysis; Geng L did radiological analysis; Zheng SS designed the study; and all authors have read and approved the final version to be published.
Supported by National Natural Science Foundation of China, No. 81373160.
Ethics approval: The study was reviewed and approved by the Zhejiang University Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare that there is no conflict of interest in this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shu-Sen Zheng, MD, PhD, Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China. shusenzheng@zju.edu.cn
Telephone: +86-571-87236739 Fax: +86-571-87236739
Received: January 19, 2015
Peer-review started: January 20, 2015
First decision: February 10, 2015
Revised: February 26, 2015
Accepted: April 9, 2015
Article in press: April 9, 2015
Published online: May 28, 2015
Abstract

Sinusoidal obstruction syndrome (SOS), previously known as hepatic veno-occlusive disease, is a rare disorder in solid organ transplant patients, and is an uncommon complication after liver transplantation. Severe SOS with hepatic failure causes considerable mortality. Tacrolimus has been reported to be an offending agent, which potentially plays a role in the pathophysiological process of SOS. SOS due to tacrolimus has been reported in lung and pancreatic transplantations, but has never been described in a liver transplant recipient. Herein, we present a case of SOS after liver transplantation, which was possibly related to tacrolimus. A 27-year-old man developed typical symptoms of SOS with painful hepatomegaly, ascites and jaundice after liver transplantation, which regressed following withdrawal of tacrolimus. By excluding other possible predisposing factors, we concluded that tacrolimus was the most likely cause of SOS.

Keywords: Liver transplantation, Sinusoidal obstruction syndrome, Veno-occlusive disease, Tacrolimus, Predisposing factor

Core tip: We describe a rare case of sinusoidal obstruction syndrome following liver transplantation, which was possibly related to tacrolimus. We believe that this condition is uncommon and has rarely been reported in liver transplant recipients.