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

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; Rohesh J. Fernando

doi:10.1053/j.jvca.2023.03.044

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

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, Rohesh J. Fernando

Division of Cardiothoracic Anesthesiology

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1 Scopus citations

Abstract

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. 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.

Original language	English
Pages (from-to)	1487-1494
Number of pages	8
Journal	Journal of Cardiothoracic and Vascular Anesthesia
Volume	37
Issue number	8
DOIs	https://doi.org/10.1053/j.jvca.2023.03.044
State	Published - Aug 2023

Keywords

orthotopic heart transplant
posterior reversible encephalopathy syndrome
reversible cerebral vasospasm syndrome
reversible posterior leukoencephalopathy syndrome
tacrolimus

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10.1053/j.jvca.2023.03.044

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Bloom, J., Collins, M. L., Belovsky, M. P., Feduska, E., Schofield, P., Leong, R., Augoustides, J. G., Lembrikov, I., Kogan, A., Frogel, J., Rajkumar, K. P., Hicks, M. H., & Fernando, R. J. (2023). Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome? Journal of Cardiothoracic and Vascular Anesthesia, 37(8), 1487-1494. https://doi.org/10.1053/j.jvca.2023.03.044

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

abstract = "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. 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.",

keywords = "orthotopic heart transplant, posterior reversible encephalopathy syndrome, reversible cerebral vasospasm syndrome, reversible posterior leukoencephalopathy syndrome, tacrolimus",

author = "Jamie Bloom and Collins, {Micaela Langille} and Belovsky, {Mia P.} and Eric Feduska and Patrick Schofield and Ron Leong and Augoustides, {John G.} and Ilya Lembrikov and Alexander Kogan and Jonathan Frogel and Rajkumar, {Karuna Puttur} and Hicks, {Megan H.} and Fernando, {Rohesh J.}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = aug,

doi = "10.1053/j.jvca.2023.03.044",

language = "English",

volume = "37",

pages = "1487--1494",

journal = "Journal of Cardiothoracic and Vascular Anesthesia",

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Bloom, J, Collins, ML, Belovsky, MP, Feduska, E, Schofield, P, Leong, R, Augoustides, JG, Lembrikov, I, Kogan, A, Frogel, J, Rajkumar, KP, Hicks, MH & Fernando, RJ 2023, 'Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome?', Journal of Cardiothoracic and Vascular Anesthesia, vol. 37, no. 8, pp. 1487-1494. https://doi.org/10.1053/j.jvca.2023.03.044

Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome? / Bloom, Jamie; Collins, Micaela Langille; Belovsky, Mia P. et al.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 37, No. 8, 08.2023, p. 1487-1494.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient

T2 - A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome?

AU - Bloom, Jamie

AU - Collins, Micaela Langille

AU - Belovsky, Mia P.

AU - Feduska, Eric

AU - Schofield, Patrick

AU - Leong, Ron

AU - Augoustides, John G.

AU - Lembrikov, Ilya

AU - Kogan, Alexander

AU - Frogel, Jonathan

AU - Rajkumar, Karuna Puttur

AU - Hicks, Megan H.

AU - Fernando, Rohesh J.

PY - 2023/8

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AB - 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. 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.

KW - orthotopic heart transplant

KW - posterior reversible encephalopathy syndrome

KW - reversible cerebral vasospasm syndrome

KW - reversible posterior leukoencephalopathy syndrome

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SP - 1487

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JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

IS - 8

ER -

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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