AI Article Synopsis
- Short bowel syndrome (SBS) results from significant small intestine removal, leading to issues like diarrhea and difficulties with drug absorption, which can complicate kidney transplantation.* -
- A case study is presented of an 18-month-old boy with SBS who successfully underwent kidney transplantation and maintained good health for four years without needing intestinal surgery.* -
- The immunosuppressive treatment using prednisolone, tacrolimus, and mycophenolate mofetil worked effectively in this patient, suggesting these drugs are viable options for others with SBS undergoing transplantation.*
Article Abstract
Background: Short bowel syndrome (SBS) is a malabsorptive condition that develops as a result of massive resection of the small intestine and causes morbidities such as chronic diarrhea, dehydration attacks, parenteral nutrition (PN) dependence, and recurrent infections. Kidney transplantation in this patient group may be complicated by aforementioned morbidities, as well as the absorption problems of immunosuppressive drugs.
Methods: We report the first pediatric patient (18-month-old male) with SBS secondary to volvulus who underwent a successful living related kidney transplantation with a primary diagnosis of autosomal recessive polycystic kidney disease and had a successful 4-year follow-up without intestinal transplantation.
Results: Tacrolimus, mycophenolate mofetil (MMF), and prednisolone were administered for maintenance of immunosuppression after transplantation. The patient reached therapeutic trough levels of tacrolimus with usual doses. The 4-year renal survival was excellent without a clinical evidence of rejection, despite long-term necessity of PN and intravenous fluids.
Conclusions: Kidney transplantation should not be avoided in patients with SBS solely because of concerns about the effectiveness of immunosuppressive therapy. Prednisolone, tacrolimus, and MMF combination was effective in our case, and these drugs can be considered as first-line agents in these patients.
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| http://dx.doi.org/10.1111/petr.14889 | DOI Listing |
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