Chronic Allograft Enteropathy Treated with Vedolizumab: A Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-01-01 DOI:10.1016/j.transproceed.2024.11.021

Guido Trentadue , Gursah Kats-Ugurlu , Tjasso Blokzijl , Jan Willem Haveman , Klaas Nico Faber , Gerard Dijkstra

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引用次数: 0

Abstract

Introduction

The most common cause of late graft loss in intestinal transplantation is chronic allograft enteropathy (CAE). The diagnosis is often delayed because of late symptoms and signs, and the only available treatment is graft enterectomy. We present the first case of CAE successfully treated with a gut-specific integrin blocker.

Case Report

We present a patient who developed CAE 15 years after transplantation and was treated with vedolizumab, a gut-specific integrin blocker that is used for inflammatory bowel disease, thereby avoiding complete graft resection. We show the clinical, endoscopic, radiological, serological, and histopathological course of CAE beginning with discovery of the first signs of disease until 15 months after the start of vedolizumab treatment.

Conclusion

To our knowledge, this case represents the first use of vedolizumab in such a circumstance and provides evidence of its usefulness as a rescue therapy for chronic intestinal rejection to, at least, extend graft survival.

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Vedolizumab治疗慢性同种异体肠病1例

肠移植晚期移植物丧失最常见的原因是慢性同种异体移植物肠病（CAE）。由于症状和体征较晚，诊断往往被延误，唯一可用的治疗是移植物肠切除术。我们提出了第一例CAE成功治疗与肠道特异性整合素阻滞剂。病例报告：我们报告了一名移植后15年出现CAE的患者，并接受了vedolizumab治疗，vedolizumab是一种用于炎症性肠病的肠道特异性整合素阻滞剂，从而避免了完全的移植物切除。我们展示了CAE的临床、内窥镜、放射学、血清学和组织病理学过程，从发现疾病的第一个迹象开始，直到韦多单抗治疗开始后15个月。结论：据我们所知，该病例代表了vedolizumab在这种情况下的首次使用，并提供了其作为慢性肠道排斥反应抢救治疗的有效性的证据，至少可以延长移植物的存活时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.