FK506-INDUCED NEUROTOXICITY IN LIVER-TRANSPLANTATION

We report FK506-induced neurotoxicity in 14 of 44 consecutive patients following orthoptic liver transplantation. In 10 of these 14 patients , postural hand tremors were found in the first weeks following surger y, transient apraxia of speech in 3, and generalized tonic-clonic seiz ures were noted in 2 patients. Other manifestations included nightmare s, agitation, and acute delirium. Reduction of the FK506 dose resulted in resolution of symptoms, but in 1 patient mild speech difficulties and in 3 patients a fine tremor remained. Blood and plasma levels of F K506 were similar in patients with arid without neurotoxicity. FK506 n eurotoxicity in patients with liver transplantation commonly results i n transient neurological manifestations. The incidence of neurotoxicit y in FK506 is dramatically reduced in maintenance doses of 0.075 mg/kg twice a day.