Long-term outcome of living related renal transplantation in a patient with short bowel syndrome

Ikuo Takeda, Naoki Kawagishi, Satoshi Sekiguchi, Yorihiro Akamatsu, Kazushige Sato, Shigehito Miyagi, Keisei Fujimori, Susumu Satomi

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3 Citations (Scopus)

Abstract

Short-bowel syndrome (SBS) is defined as the malabsorptive state that occurs after extensive resection of the small intestine. In patients with SBS, oral administration of drugs usually becomes difficult because of the severity of intestinal failure. We describe a successful living related renal transplantation (LRRTx) in an 18-year-old male with SBS. Shortly after birth, the patient developed necrotizing enterocolitis requiring massive resection of the small intestine, which resulted in SBS. At seven years of age, the patient developed proteinuria and was diagnosed as focal segmental glomerulosclerosis (FSGS). His kidney function was gradually deteriorated toward the end-stage renal failure. The patient received LRRTx at age of 18 years. To evaluate the absorption capacity of the patient, we investigated pharmacokinetics of calcineurine inhibitors (tacrolimus and cyclosporine). The drug concentration, which is sufficient to provide effective immunosuppression, was achieved with cyclosporine, but not with tacrolimus. The patient therefore received a triple immunosuppressive therapy with oral cyclosporine, methyl-prednisolone and mycophenolate mofetil. To prevent both recurrent FSGS and rejection, we repeatedly analyzed the trough level and the pharmacokinetics of cyclosporine after LRRTx. The patient was successfully treated with oral immunosuppression for over 5 years, without hemodialysis. To our knowledge, this is the first report showing the long-term outcome of LRRTx treated with oral cyclosporine in a patient with SBS.

Original languageEnglish
Pages (from-to)113-118
Number of pages6
JournalTohoku Journal of Experimental Medicine
Volume221
Issue number2
DOIs
Publication statusPublished - 2010 May 21

Keywords

  • Calcineurine inhibitor
  • Living related renal transplantation
  • Oral immunosuppressive therapy
  • Pharmacokinetics
  • Short bowel syndrome

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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  • Cite this

    Takeda, I., Kawagishi, N., Sekiguchi, S., Akamatsu, Y., Sato, K., Miyagi, S., Fujimori, K., & Satomi, S. (2010). Long-term outcome of living related renal transplantation in a patient with short bowel syndrome. Tohoku Journal of Experimental Medicine, 221(2), 113-118. https://doi.org/10.1620/tjem.221.113