Successful Treatment of Life-Threatening Small Bowel Bleeding With Thalidomide After Living Donor Kidney Transplantation: A Case Report
| Autor: | Hyung Sub Park, Kwon Cheol Yoo, Taeseung Lee, Chang Sik Shin, Daehwan Kim, Yoonjung Heo |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Vital signs Angiogenesis Inhibitors Tacrolimus Diabetic nephropathy Postoperative Complications Refractory Melena medicine Living Donors Humans Kidney transplantation Aged Transplantation business.industry Middle Aged medicine.disease Kidney Transplantation Surgery Thalidomide medicine.symptom business Complication Gastrointestinal Hemorrhage Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation proceedings. 51(9) |
| ISSN: | 1873-2623 |
| Popis: | Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immunosuppressant use. We present a case of refractory small bowel bleeding treated successfully with thalidomide after multiple failed attempts of conventional treatment. A 65-year-old male patient with diabetic nephropathy underwent living donor kidney transplantation. The surgery was uneventful, however, he developed immunosuppressant-induced melena with unstable vital signs 11 days later. There were a total of 4 bleeding episodes until the 90th postoperative day, and he received a total of 290 units of red blood cell transfusion during this period. Endoscopic clipping, transarterial embolization, and 2 surgical interventions failed to stop the bleeding. A trial of thalidomide 100 mg per day finally stopped the bleeding and the patient was discharged on the 110th postoperative day with a functioning renal graft. This case shows that thalidomide can be a safe option to treat immunosuppressant-induced refractory gastrointestinal bleeding in the setting of kidney transplantation. Additionally, this is the first case that reports the survival of a renal graft after more than 3000 mL of transfusion. |
| Databáze: | OpenAIRE |
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