Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide
Among patients with short bowel syndrome who commonly have kidney disease, kidney transplantation remains challenging. We describe the clinicopathologic course of a 59-year old man with short bowel syndrome secondary to Crohn’s disease who underwent a deceased donor kidney transplant that was compli...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2020/8819345 |
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| author | Elizabeth Abou Diwan Ankit B. Patel Alex G. Cuenca Nahel Elias Hannah M. Gilligan Eliot Heher David E. Leaf David Wojciechowski Kassem Safa |
| author_facet | Elizabeth Abou Diwan Ankit B. Patel Alex G. Cuenca Nahel Elias Hannah M. Gilligan Eliot Heher David E. Leaf David Wojciechowski Kassem Safa |
| author_sort | Elizabeth Abou Diwan |
| collection | DOAJ |
| description | Among patients with short bowel syndrome who commonly have kidney disease, kidney transplantation remains challenging. We describe the clinicopathologic course of a 59-year old man with short bowel syndrome secondary to Crohn’s disease who underwent a deceased donor kidney transplant that was complicated by recurrent acute kidney allograft injury due to volume depletion from diarrhea, ultimately requiring the placement of permanent intravenous access for daily volume expansion at home resulting in the recovery of allograft function. Teduglutide treatment at 1.8 years post-transplant led to a dramatic decrease in diarrhea. A literature review of similar cases yielded 18 patients who underwent 19 kidney transplants. Despite high rates of complications, at the time of last follow-up (median 2.1 years [0.04-7]), 94% of the patients were still alive and 89% had functioning allografts, with a median eGFR of 37.5 [14-122] ml/min/1.73m2. In conclusion, despite high rates of complications, kidney transplantation in patients with short bowel syndrome is associated with acceptable short- and midterm outcomes. Further, we report for the first time the effects of the glucagon-like peptide-2 analogue teduglutide for short bowel syndrome in a kidney transplant recipient. |
| format | Article |
| id | doaj-art-88dfd64032a345f592ffb843ba861f08 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-88dfd64032a345f592ffb843ba861f082025-08-20T03:38:06ZengWileyCase Reports in Transplantation2090-69432090-69512020-01-01202010.1155/2020/88193458819345Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of TeduglutideElizabeth Abou Diwan0Ankit B. Patel1Alex G. Cuenca2Nahel Elias3Hannah M. Gilligan4Eliot Heher5David E. Leaf6David Wojciechowski7Kassem Safa8American University of Beirut Medical School, Beirut, LebanonDivision of Renal Medicine, Brigham and Women’s Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USAHarvard Medical School, Boston, MA, USADivision of Nephrology, Massachusetts General Hospital, Boston, MA, USADivision of Nephrology, Massachusetts General Hospital, Boston, MA, USADivision of Renal Medicine, Brigham and Women’s Hospital, Boston, MA, USADivision of Nephrology, Massachusetts General Hospital, Boston, MA, USADivision of Nephrology, Massachusetts General Hospital, Boston, MA, USAAmong patients with short bowel syndrome who commonly have kidney disease, kidney transplantation remains challenging. We describe the clinicopathologic course of a 59-year old man with short bowel syndrome secondary to Crohn’s disease who underwent a deceased donor kidney transplant that was complicated by recurrent acute kidney allograft injury due to volume depletion from diarrhea, ultimately requiring the placement of permanent intravenous access for daily volume expansion at home resulting in the recovery of allograft function. Teduglutide treatment at 1.8 years post-transplant led to a dramatic decrease in diarrhea. A literature review of similar cases yielded 18 patients who underwent 19 kidney transplants. Despite high rates of complications, at the time of last follow-up (median 2.1 years [0.04-7]), 94% of the patients were still alive and 89% had functioning allografts, with a median eGFR of 37.5 [14-122] ml/min/1.73m2. In conclusion, despite high rates of complications, kidney transplantation in patients with short bowel syndrome is associated with acceptable short- and midterm outcomes. Further, we report for the first time the effects of the glucagon-like peptide-2 analogue teduglutide for short bowel syndrome in a kidney transplant recipient.http://dx.doi.org/10.1155/2020/8819345 |
| spellingShingle | Elizabeth Abou Diwan Ankit B. Patel Alex G. Cuenca Nahel Elias Hannah M. Gilligan Eliot Heher David E. Leaf David Wojciechowski Kassem Safa Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide Case Reports in Transplantation |
| title | Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide |
| title_full | Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide |
| title_fullStr | Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide |
| title_full_unstemmed | Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide |
| title_short | Short Bowel Syndrome and Kidney Transplantation: Challenges, Outcomes, and the Use of Teduglutide |
| title_sort | short bowel syndrome and kidney transplantation challenges outcomes and the use of teduglutide |
| url | http://dx.doi.org/10.1155/2020/8819345 |
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