Reported side-effects of tacrolimus, a potent immunosuppressive agent,
have not included cardiotoxicity. We describe 5 consecutive paediatri
c transplant recipients (3 small bowel with or without liver and 2 liv
er) who received tacrolimus. 2 developed congestive heart failure and
hypertrophic obstructive cardiomyopathy which resolved after changing
to cyclosporin. In the other 3 patients the cardiomyopathy regressed o
r improved with a lower dose of tacrolimus or after stopping the drug.