{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:45:27Z","timestamp":1753879527515,"version":"3.41.2"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,5,18]],"date-time":"2018-05-18T00:00:00Z","timestamp":1526601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Xenotransplantation"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Tacrolimus\u2010associated thrombotic microangiopathy (<jats:styled-content style=\"fixed-case\">TA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>) is a rare complication. <jats:styled-content style=\"fixed-case\">TA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content> is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage due to thrombus. We report asymptomatic <jats:styled-content style=\"fixed-case\">TA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content> diagnosed by laboratory tests in pig\u2010to\u2010rhesus corneal xenotransplantation. Corneal transplantation had been conducted from a wild\u2010type <jats:styled-content style=\"fixed-case\">SNU<\/jats:styled-content> miniature pig to a rhesus macaque. The veterinary records were retrospectively reviewed in this case. The immunosuppressive regimen consisted of rituximab, basiliximab, and <jats:styled-content style=\"fixed-case\">IVI<\/jats:styled-content>g as inductive therapies, and steroids with tacrolimus (0.1 mg\/kg\/day) as maintenance therapies. Although there were no clinical symptoms, increased levels of lactate dehydrogenase, total bilirubin, blood urea nitrogen, and creatinine and decreased levels of hemoglobin and platelet were observed in laboratory tests on Day (D) 61. Systemic <jats:styled-content style=\"fixed-case\">TA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content> was tentatively diagnosed. Tacrolimus was discontinued starting on D71. Dalteparin, clopidogrel bisulfate (D77\u2010D99), and <jats:styled-content style=\"fixed-case\">IVI<\/jats:styled-content>g (D72) were administered as a conservative treatment. Abnormal laboratory results were reversed on D99. When low\u2010dose tacrolimus (0.07\u00a0mg\/kg\/day) was re\u2010administered on D131 to prevent rejection of the graft, <jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content> was detected again by laboratory tests on D161, confirming the initial diagnosis. Discontinuation of tacrolimus on D162 and re\u2010administration of Dalteparin (D161\u2010D196) corrected the laboratory values on D161. This report shows that in pig\u2010to\u2010rhesus corneal xenotransplantation, clinically asymptomatic <jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content> can be induced by tacrolimus, and the discontinuation of tacrolimus and administration of anticoagulant seems sufficient to correct the laboratory <jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/xen.12404","type":"journal-article","created":{"date-parts":[[2018,5,19]],"date-time":"2018-05-19T04:39:58Z","timestamp":1526704798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Tacrolimus\u2010induced asymptomatic thrombotic microangiopathy diagnosed by laboratory tests in pig\u2010to\u2010rhesus corneal xenotransplantation: A case report"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0906-0117","authenticated-orcid":false,"given":"Jong\u2010Min","family":"Kim","sequence":"first","affiliation":[{"name":"Xenotransplantation Research Center  Seoul Korea"},{"name":"Institute of Endemic Diseases  Seoul Korea"},{"name":"Cancer Research Institute  Seoul Korea"},{"name":"Biomedical Research Institute Seoul National University Hospital  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaeyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Laboratory Of Ocular Regenerative Medicine and Immunology Seoul Artificial Eye Center Seoul National University Hospital Biomedical Research Institute  Seoul Korea"},{"name":"Department of Ophthalmology Seoul National University College of Medicine  Seoul Korea"},{"name":"Department of Ophthalmology Seoul Paik Hospital Inje University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9916-0332","authenticated-orcid":false,"given":"Se\u2010Hyun","family":"Choi","sequence":"additional","affiliation":[{"name":"Laboratory Of Ocular Regenerative Medicine and Immunology Seoul Artificial Eye Center Seoul National University Hospital Biomedical Research Institute  Seoul Korea"},{"name":"Department of Ophthalmology Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun\u2010Seop","family":"Shin","sequence":"additional","affiliation":[{"name":"Xenotransplantation Research Center  Seoul Korea"},{"name":"Institute of Endemic Diseases  Seoul Korea"},{"name":"Cancer Research Institute  Seoul Korea"},{"name":"Biomedical Research Institute Seoul National University Hospital  Seoul Korea"},{"name":"Department of Microbiology and Immunology Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byoung\u2010Hoon","family":"Min","sequence":"additional","affiliation":[{"name":"Xenotransplantation Research Center  Seoul Korea"},{"name":"Cancer Research Institute  Seoul Korea"},{"name":"Department of Microbiology and Immunology Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Young","family":"Jeong","sequence":"additional","affiliation":[{"name":"Xenotransplantation Research Center  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ga\u2010Eul","family":"Lee","sequence":"additional","affiliation":[{"name":"Xenotransplantation Research Center  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min\u2010Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"Xenotransplantation Research Center  Seoul 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