Outcome of exfoliative rejection after isolated intestinal transplantation in an adult: case report
| Autor: | Fernand Girard-Pipau, C. Laffont, Marie-Christine Saint-Paul, A. Tzakis, X. Hébuterne, Stéphane M. Schneider, Gilbert Zeanandin, Thierry Yandza, Daniel Benchimol, Geoffroy Vanbiervliet, Amine Rahili, M. Gari-Toussaint, Jean Gugenheim, B. Goubaux, V. Miton, G Bernard, L. Badan, S. Nishida |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Graft Rejection Male Reoperation Short Bowel Syndrome medicine.medical_specialty Abdominal pain medicine.drug_class Biopsy Multiple Organ Failure Gastroenterology Bolus (medicine) Fatal Outcome Postoperative Complications Weight loss Internal medicine Intestine Small medicine Humans Antilymphocyte Serum Transplantation medicine.diagnostic_test Thymoglobulin business.industry Adult case Endoscopy Surgery Corticosteroid medicine.symptom business Intestinal Obstruction |
| Zdroj: | Transplantation proceedings. 42(1) |
| ISSN: | 1873-2623 |
| Popis: | A 34-year-old-man with short-bowel syndrome received an isolated small bowel graft. On postoperative day (POD) 11, ileal biopsy specimen demonstrated mild to moderate rejection that did not respond to corticosteroid bolus therapy. On POD 14, endoscopy and histologic examination revealed exfoliative rejection that was not controlled after 14 days of therapy with thymoglobulin. On POD 95, the patient underwent surgery again because of intestinal obstruction. The graft was removed 6 months after transplantation because of continuous severe abdominal pain with weight loss. After enterectomy, the patient developed multiple-organ failure and died on POD day 8. This case underlines the severity of exfoliative rejection and suggests that early enterectomy be performed when the diagnosis is made, before deterioration of clinical status and development of infectious and nutritional complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect