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Short Bowel Syndrome Is Not a Contraindication for Kidney Transplantation
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 transplantati...
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Published in: | Pediatric transplantation 2024-12, Vol.28 (8), p.e14889-n/a |
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Main Authors: | , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
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Summary: | 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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ISSN: | 1397-3142 1399-3046 1399-3046 |
DOI: | 10.1111/petr.14889 |