Tamoxifen therapy in kidney-transplant patients presenting with severe encapsulating peritoneal sclerosis after treatment for acute humoral rejection.
Exp Clin Transplant
; 7(3): 164-7, 2009 Sep.
Article
em En
| MEDLINE
| ID: mdl-19715526
ABSTRACT
OBJECTIVES:
Encapsulating peritoneal sclerosis is a rare but serious complication in patients undergoing peritoneal dialysis. Its mortality rate is approximately 30%, despite treatment with total parenteral nutrition, surgery, tamoxifen, or immunosuppressants. MATERIALS ANDMETHODS:
Of 991 kidney transplants performed at our institution over 9 years, 50 patients were treated for chronic peritoneal dialysis at the time of transplant.RESULTS:
Two cases of encapsulating, peritoneal sclerosis occurred in patients receiving pretransplant peritoneal dialysis. Both had received intensive posttransplant treatment for acute humoral rejection. Encapsulating peritoneal sclerosis occurred at 3 months and 4 months after the transplant. Both presented with intestinal pain and gut obstruction. They were given total parenteral nutrition plus tamoxifen (20 mg/d) for 3 months. Outcomes were favorable for 1, though there was no improvement for the second patient, who was then also given sirolimus. He died later from multiorgan failure secondary to digestive-related sepsis, and encapsulating, peritoneal, sclerosis-related symptoms.CONCLUSIONS:
When encapsulating, peritoneal sclerosis occurs after kidney transplant, tamoxifen therapy could be implemented.
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Bases de dados:
MEDLINE
Assunto principal:
Tamoxifeno
/
Transplante de Rim
/
Diálise Peritoneal Ambulatorial Contínua
/
Plasmaferese
/
Fibrose Peritoneal
/
Imunidade Humoral
/
Rejeição de Enxerto
/
Imunossupressores
Tipo de estudo:
Etiology_studies
Limite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Exp Clin Transplant
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
França