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Successful Treatment of Life-Threatening Small Bowel Bleeding With Thalidomide After Living Donor Kidney Transplantation: A Case Report
- Source :
- Transplantation proceedings. 51(9)
- Publication Year :
- 2019
-
Abstract
- Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immunosuppressant use. We present a case of refractory small bowel bleeding treated successfully with thalidomide after multiple failed attempts of conventional treatment. A 65-year-old male patient with diabetic nephropathy underwent living donor kidney transplantation. The surgery was uneventful, however, he developed immunosuppressant-induced melena with unstable vital signs 11 days later. There were a total of 4 bleeding episodes until the 90th postoperative day, and he received a total of 290 units of red blood cell transfusion during this period. Endoscopic clipping, transarterial embolization, and 2 surgical interventions failed to stop the bleeding. A trial of thalidomide 100 mg per day finally stopped the bleeding and the patient was discharged on the 110th postoperative day with a functioning renal graft. This case shows that thalidomide can be a safe option to treat immunosuppressant-induced refractory gastrointestinal bleeding in the setting of kidney transplantation. Additionally, this is the first case that reports the survival of a renal graft after more than 3000 mL of transfusion.
- Subjects :
- Male
medicine.medical_specialty
Gastrointestinal bleeding
Vital signs
Angiogenesis Inhibitors
Tacrolimus
Diabetic nephropathy
Postoperative Complications
Refractory
Melena
medicine
Living Donors
Humans
Kidney transplantation
Aged
Transplantation
business.industry
Middle Aged
medicine.disease
Kidney Transplantation
Surgery
Thalidomide
medicine.symptom
business
Complication
Gastrointestinal Hemorrhage
Immunosuppressive Agents
medicine.drug
Subjects
Details
- ISSN :
- 18732623
- Volume :
- 51
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Transplantation proceedings
- Accession number :
- edsair.doi.dedup.....3bc53ff6f42e99437de16c346d26ee40