İlkay ERDOĞAN, YELDA BİLGİNER, ALİ DÜZOVA, Nesrin BEŞBAŞ

Sinus tachycardia related to tacrolimus after kidney transplantation in children and young adults

SUMMARY: Erdoğan İ, Bilginer Y, Düzova A, Beşbaş N. Sinus tachycardia related to tacrolimus after kidney transplantation in children and young adults. Turk J Pediatr 2015; 57: 587-591. Tacrolimus is a potent immunosuppressive agent widely used after organ transplantation. In this present study we present eight patients who complained of palpitation after kidney transplantation. Eight out of 31 patients who received tacrolimus after kidney transplantation suffered from tachycardia. Resting electrocardiography, 24 hours Holter monitorization, echocardiography were performed, and serum levels of cardiac troponin T, creatine kinase, CKMB, brain natriuretic peptide and tacrolimus were measured. The median time to palpitation after kidney transplantation was 30 days in seven patients, and one patient complained of palpitation five years after transplantation. Cardiovascular assessment revealed sinus tachycardia in all patients. Betablocker was instituted in five patients. After two months all patients were asymptomatic and their pulse rates were within normal limits. Transient sinus tachycardia is a frequent adverse event during tacrolimus therapy in children and young adults, at therapeutic levels. Patients may benefit from beta-blockers

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1. Ağırbaşlı M, Papila-Topal N, Öğütmen B, et al. The blockade of the renin-angiotensin system reverses tacrolimus related cardiovascular toxicity at the histopathological level. J Renin Angiotensin Aldosterone Syst 2007; 8: 54-58.

2. Atkison P, Joubert G, Barron A, et al. Hypertrophic cardiomyopathy associated with tacrolimus in pediatric transplant patients. Lancet 1995; 345: 894-896.

3. Seino Y, Hori M, Sonoda T. Multicenter prospective investigation on cardiovascular adverse effects of tacrolimus in kidney transplantation. Cardiovasc Drugs Ther 2003; 17:141-149.

4. Kim BR1, Shin HS, Jung YS, Rim H. A case of tacrolimus-induced supraventricular arrhythmia after kidney transplantation. Sao Paulo Med J 2013; 131: 205-207.

5. Takahara S., Miki T, Hatori M, Kokado Y, Wang J, Okuyama A. A comparative study of FK506 granules and capsules in renal transplant recipients. Transpl Int 1998; 11: 181-185.

6. Gardiner S M, March J E, Kemp P A, Fallgren B, Bennett T. Regional haemodynamic effects of cyclosporine A, tacrolimus and sirolimus in consc ious rats. Br J Pharmacol 2004; 141: 634-643.

7. Ikitimur B, Cosansu K, Karadag B et al. Long-Term Impact of Different Immunosuppressive Drugs on QT and PR Intervals in Renal Transplant Patients. Ann Noninvasive Electrocardiol 2015; 20: 426-432.

8. Nakata Y, Yoshibayashi M, Yonemura T, et al. Tacrolimus and myocardial hypertrophy. Transplantation 2000; 15; 69: 1960-1962.

9. Pirsch JD, Miller J, Deierhoi MH, Vincenti F, Filo RS. A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group. Transplantation 1997; 63: 977-983.

10. Brillantes AB, Ondrias K, Scott A et al. Stabilization of calcium releasing channel (ryanodine receptor) function by FK-506-binding protein. Cell 1994; 77: 513-523.