Back to Search
Start Over
Recurrent Cytomegalovirus Infection Controlled by the Introduction of Everolimus in a Simultaneous Pancreas-Kidney Transplantation Recipient: A Case Report
- Source :
- Transplantation Proceedings. 54:1615-1617
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- In simultaneous pancreas-kidney transplantation (SPK) recipients, cytomegalovirus (CMV) infection is a major complication that has been associated with the use of tacrolimus (TAC)-based immunosuppression. As one of the immunosuppressive drug options, the use of mammalian target of rapamycin inhibitors (mTORi) results in reduced rates of CMV infection in the field of solid organ transplantation. However, little is known about mTORi usage in pancreas transplantation. We report a case of recurrent CMV infection that was controlled by the introduction of mTORi (everolimus) in addition to a TAC-based immunosuppression regimen in SPK. A 52-year-old man underwent SPK. Graft duodenal perforation occurred on the 13th day of surgery, and graft duodenal resection was performed after long-term abscess drainage treatment. After graft duodenal resection, he was diagnosed with CMV viremia, and valganciclovir was started. However, because of recurrent febrile neutropenia caused by cytopenia as a side effect of valganciclovir, there was a repeated need for granulocyte-colony stimulating factor treatment. Immunosuppressive drug taper adjustment was attempted to control recurrent CMV viremia, and everolimus was introduced with the aim of reducing the dose of TAC and mycophenolate mofetil. This resulted in a continuously negative CMV antigenemia test and a stable general condition. Understanding the characteristics of various immunosuppressive agents and appropriately controlling and managing infectious diseases is crucial for the good postoperative management of patients with SPK.
- Subjects :
- Graft Rejection
Male
Transplantation
TOR Serine-Threonine Kinases
Graft Survival
Middle Aged
Mycophenolic Acid
Kidney Transplantation
Tacrolimus
Colony-Stimulating Factors
Cytomegalovirus Infections
Humans
Valganciclovir
Surgery
Everolimus
Pancreas Transplantation
Viremia
Pancreas
Immunosuppressive Agents
Subjects
Details
- ISSN :
- 00411345
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Transplantation Proceedings
- Accession number :
- edsair.doi.dedup.....5fd4f0c7c886fe598dd0e72c421f21ff