Use of vedolizumab in pediatric intestinal transplant rejection.

Intestinal Failure (New York, N.Y.) Pub Date : 2025-12-30 eCollection Date: 2026-01-01 DOI:10.1016/j.intf.2025.100340

Shahira Ghobrial, Dimitrios Moris, Carolina Rumbo, Stuart S Kaufman, Gabriel Gondolesi, Dong Hyang Kwon, Yoshinori Takeda, Nada Yazigi, Udeme D Ekong, Thomas M Fishbein, Cal S Matsumoto, Alexander Kroemer, Khalid Khan

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Abstract

Background: Blockade of α4β7 integrin cell adhesion receptors on activated lymphocytes with the monoclonal antibody vedolizumab (VDZ) is efficacious in treatment of inflammatory bowel disease and most probably intestinal graft versus host disease (GVHD) after stem cell transplantation. Recently, there have been reports indicating that VDZ may be similarly effective in the treatment of acute rejection after intestinal transplantation (ITx). Herein, we report 3 additional cases.

Case presentation: Mucosal recovery was achieved in 2 of the 3 patients, within 6 days after the first VDZ dose in one and with early restoration of enteral nutrition in the other. There was no response to VDZ in the third case. Complications potentially attributable to VDZ included graft pneumatosis and late-onset histoplasmosis.

Conclusions: These cases describe both benefits and limitations of VDZ in ITx. They also suggest that VDZ may be useful in post-ITx rejection prophylaxis and for the treatment of intestinal GVHD.

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韦多单抗在儿童肠道移植排斥反应中的应用。

背景：单克隆抗体vedolizumab （VDZ）阻断活化淋巴细胞上α4β7整合素细胞粘附受体，可有效治疗干细胞移植后炎症性肠病和最有可能的肠道移植物抗宿主病（GVHD）。最近，有报道表明VDZ在治疗肠移植后急性排斥反应（ITx）中可能同样有效。在此，我们报告另外3例。病例介绍：3例患者中2例粘膜恢复，1例在首次服用VDZ后6天内，另1例早期恢复肠内营养。第三例VDZ无应答。可能归因于VDZ的并发症包括移植物肺病和迟发性组织浆菌病。结论：这些病例描述了VDZ治疗ITx的益处和局限性。他们还表明，VDZ可能有助于itx后排斥反应的预防和肠道GVHD的治疗。

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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Intestinal Failure (New York, N.Y.)

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