Highlights the potential for immunosuppressant-induced torsades de pointes in pediatric heart transplant patients experiencing acute rejection.
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TdP reported in pediatric heart transplant rejection; hypothesis-generating for roles of repolarization heterogeneity, immunosuppressants, and AKAP9.
Torsades de pointes is a kind of life-threatening ventricular tachyarrhythmia. We report a case of torsades de pointes in an 8-year-old boy with acute rejection after orthotopic heart transplantation. The causes of torsades de pointes could be either congenital or acquired. In this case, various causes including acute rejection-related repolarisation heterogeneity, dose-dependent acquired long QT resulting from treatment with immunosuppressants, and AKAP9 (A-kinase anchoring protein 9) genetic variants are the possible mechanisms.
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Liu et al. (2020) studied this question.
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