Central nervous system toxicity induced by tacrolimus after renal transplantation

DU Chuan-fu; YU Li-xin; YAO Bing

doi:10.3321/j.issn:1673-4254.2001.04.017

Abstract：Objective To observe the central nervous system symptoms in renal transplantation recipients receiving posto- perative immunosuppressant tacrolimus (FK506). Methods The neurological symptoms resulting from FK506 administration after renal transplant in 71 recipients were observed and serum FK506 levels determined. Results During the immunosu- ppressive therapy with FK506, neurological symptoms of the central nervous system were observed in 11 patients, 3 of whom were in serious condition. One patient of the 3 with severe central neurological complications showed slight abnormalities in ECG and CT scan, while the other 2 did not. The symptoms of the majority of patients were self-limited and relieved without medical intervention, and in some cases, reduction of the dosage of FK506 was necessitated. In the most serious case, even complete withdrawal of medication failed to improve the symptoms in a short period of time. Conclusions FK506 is a potent immunosuppressant that may cause neurological complications, though mild in most cases. It should be noted that, however, normally therapeutic doses of FK506 might result in serious central nervous system symptoms in some cases, without or with only slight abnormal findings in physical, electrocardiographic or CT examination.