Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases

Ueno, Takehisa; Toyama, Chiyoshi; Deguchi, Koichi; Masahata, Kazunori; Nomura, Motonari; Watanabe, Miho; Kamiyama, Masafumi; Tazuke, Yuko; Bessho, Kazuhiko; Okuyama, Hiroomi

doi:https://doi.org/10.1016/j.transproceed.2022.01.010

Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases

Ueno, Takehisa; Toyama, Chiyoshi; Deguchi, Koichi et al.

Transplantation Proceedings, 2022, 54(2), 472-475

Number of Access:1,257（2025-07-22 21:52 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/96471

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Title	Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases
Creator	NRID 1000010456957 1000010456957 ORCID 0000-0002-4639-8814 0000-0002-4639-8814 researchmap permalink ueno-pedsurg ueno-pedsurg Scopus Author ID 21743992300 21743992300 CreatorName Ueno, Takehisa
	NRID 1000010839369 1000010839369 CreatorName Toyama, Chiyoshi
	NRID 1000000747082 1000000747082 researchmap permalink deguchi_koichi deguchi_koichi Scopus Author ID 57139781700 57139781700 CreatorName Deguchi, Koichi
	NRID 1000040588381 1000040588381 CreatorName Masahata, Kazunori
	NRID 1000040546909 1000040546909 researchmap permalink moto_pedsurg moto_pedsurg Scopus Author ID 35208741700 35208741700 ORCID 0009-0004-0959-7461 0009-0004-0959-7461 CreatorName Nomura, Motonari
	NRID 1000040791728 1000040791728 researchmap permalink miho miho Scopus Author ID 56282966800 56282966800 ORCID 0000-0001-6691-0611 0000-0001-6691-0611 CreatorName Watanabe, Miho
	NRID 1000020403074 1000020403074 researchmap permalink kamiyamapedsurg kamiyamapedsurg Scopus Author ID 55559187300 55559187300 CreatorName Kamiyama, Masafumi
	NRID 1000010397698 1000010397698 researchmap permalink yukotazuke-osaka yukotazuke-osaka Scopus Author ID 7006109798 7006109798 ORCID 0000-0002-8335-0414 0000-0002-8335-0414 CreatorName Tazuke, Yuko
	NRID 1000080423169 1000080423169 researchmap permalink KazuBe KazuBe CreatorName Bessho, Kazuhiko
	NRID 1000030252670 1000030252670 researchmap permalink okuyamahiroomi okuyamahiroomi Scopus Author ID 35496082300 35496082300 ORCID 0000-0002-1347-282X 0000-0002-1347-282X CreatorName Okuyama, Hiroomi
Description	Ueno T., Toyama C., Deguchi K., et al. Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases. Transplantation Proceedings 54, 472 (2022); https://doi.org/10.1016/j.transproceed.2022.01.010.
Abstract	Background: In patients with intestinal transplantation (ITx), renal function is easily impaired because of long-term parenteral nutrition and side effects of tacrolimus. Everolimus was used in patients with renal insufficiency in our study. Methods: We administered everolimus as a third immunosuppressive agent in addition to tacrolimus and steroids for renal sparing in patients who received ITx. We assessed everolimus levels, complications, and renal function. Results: Two patients received everolimus after ITx. Patient 1 was a 13-year-old boy who underwent ITx for an allied disorder of Hirschsprung's disease. After induction therapy with rabbit antithymocyte globulin, maintenance therapy consisted of tacrolimus and steroids. Everolimus was introduced 3 months after ITx for renal sparing. Seven months later, the patient required partial intestinal graft resection owing to bowel obstruction. Everolimus was suspended for only 2 weeks. Four years after ITx, the trough level of tacrolimus was maintained at 3 to 5 ng/mL. The trough level of everolimus was maintained at 3 to 5 ng/mL. Patient 2 was a 32-year-old man who underwent deceased ITx for short gut syndrome. Induction and maintenance immunosuppression was the same as for patient 1. Everolimus was introduced 1 month after surgery. Two years after ITx, trough levels of tacrolimus and everolimus were the same as in patient 1. No rejection was observed in either patient, and renal function was well maintained. We observed no side effects caused by everolimus. Conclusions: Everolimus could be used safely and effectively after ITx. Early use of everolimus after ITx did not affect wound healing.
Publisher	Elsevier Inc.
Source Title	Transplantation Proceedings
Volume (Issue)	54(2)
Page	472-475
Date of Issued	2022-03-01
Language	English
Handle URL	https://hdl.handle.net/11094/96471
PISSN	00411345
eISSN	18732623
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1016/j.transproceed.2022.01.010
Access Rights	open access
CopyRight	©2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Transplantation Proceedings. 2022, 54(2), p. 472-475
DC.title	Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases
DC.creator	Ueno, Takehisa
	Toyama, Chiyoshi
	Deguchi, Koichi
	Masahata, Kazunori
	Nomura, Motonari
	Watanabe, Miho
	Kamiyama, Masafumi
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
DC.publisher	Elsevier Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2022-03-01
DC.identifier	https://doi.org/10.1016/j.transproceed.2022.01.010
DC.description	Ueno T., Toyama C., Deguchi K., et al. Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases. Transplantation Proceedings 54, 472 (2022); https://doi.org/10.1016/j.transproceed.2022.01.010.
DCTERMS.abstract	Background: In patients with intestinal transplantation (ITx), renal function is easily impaired because of long-term parenteral nutrition and side effects of tacrolimus. Everolimus was used in patients with renal insufficiency in our study. Methods: We administered everolimus as a third immunosuppressive agent in addition to tacrolimus and steroids for renal sparing in patients who received ITx. We assessed everolimus levels, complications, and renal function. Results: Two patients received everolimus after ITx. Patient 1 was a 13-year-old boy who underwent ITx for an allied disorder of Hirschsprung's disease. After induction therapy with rabbit antithymocyte globulin, maintenance therapy consisted of tacrolimus and steroids. Everolimus was introduced 3 months after ITx for renal sparing. Seven months later, the patient required partial intestinal graft resection owing to bowel obstruction. Everolimus was suspended for only 2 weeks. Four years after ITx, the trough level of tacrolimus was maintained at 3 to 5 ng/mL. The trough level of everolimus was maintained at 3 to 5 ng/mL. Patient 2 was a 32-year-old man who underwent deceased ITx for short gut syndrome. Induction and maintenance immunosuppression was the same as for patient 1. Everolimus was introduced 1 month after surgery. Two years after ITx, trough levels of tacrolimus and everolimus were the same as in patient 1. No rejection was observed in either patient, and renal function was well maintained. We observed no side effects caused by everolimus. Conclusions: Everolimus could be used safely and effectively after ITx. Early use of everolimus after ITx did not affect wound healing.
DC.rights	©2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
DC.format	96471
citation_title	Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases
citation_author	Ueno, Takehisa
	Toyama, Chiyoshi
	Deguchi, Koichi
	Masahata, Kazunori
	Nomura, Motonari
	Watanabe, Miho
	Kamiyama, Masafumi
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
citation_publisher	Elsevier Inc.
citation_language	English
citation_date	2022-03-01
citation_journal_title	Transplantation Proceedings
citation_volume	54
citation_issue	2
citation_firstpage	472
citation_lastpage	475
citation_doi	https://doi.org/10.1016/j.transproceed.2022.01.010
citation_public_url	https://hdl.handle.net/11094/96471

Early Use of Everolimus as a Third Immunosuppressive Agent for Intestinal Transplantation: A Report of 2 Cases

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