Rare Case of Tacrolimus-Induced Acute Pancreatitis in a Liver Transplant Recipient

Tacrolimus-induced acute pancreatitis (TAP) is rare and requires thorough evaluation, including genetic testing, to rule out other causes. While TAP has been documented in a few cases following kidney transplantation, we report the first case of TAP in an adult after liver transplantation, with a noteworthy feature of late-onset TAP occurring more than 12 months after initiating tacrolimus therapy. This case highlights the potential for delayed onset of TAP, and we suggest that tacrolimus may warrant reclassification from category III to Ic in the drug-induced pancreatitis classification. In addition, we introduce sirolimus as a viable alternative for immunosuppression following TAP.