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Letter to the Editor: Post–Liver Transplantation Sinusoidal Obstruction Syndrome and Immunosuppressive Drugs: Causality of Mycophenolate Mofetil or Tacrolimus?

We read with great interest Poli et al's case report describing a post-Liver Transplantation (LT) Sinusoidal Obstruction Syndrome (SOS) induced by Mycophenolate Mofetil (MMF). This case led us to make two comments.SOS is considered a rare liver disorder in the post-LT setting. Acute rejection, CMV reactivation, advanced age, and underlying vascular disease may be triggers for SOS2 . Finally, immunosuppressive drugs have been implicated, i.e. azathioprine historically and MMF and tacrolimus more recently, even rarely.