Matches in SemOpenAlex for { <https://semopenalex.org/work/W3136297246> ?p ?o ?g. }
Showing items 1 to 89 of
89
with 100 items per page.
- W3136297246 endingPage "S492" @default.
- W3136297246 startingPage "S491" @default.
- W3136297246 abstract "<h3>Introduction</h3> The management of immunosuppressants constitutes a challenge in clinical practice to maintain drug exposure within therapeutic target because of its variable pharmacokinetics. <h3>Case Report</h3> A 38 years-old male with an advanced non-compacted cardiomyopathy underwent orthotopic heart transplantation (OHT). On the 4<sup>th</sup> day post-op he developed a paralytic ileum complicated with cecum perforation and faecaloid peritonitis that required emergent right hemicolectomy and terminal ileostomy. At discharge, his treatment was tacrolimus, mycophenolate mofetil (MMF) and prednisone.During follow-up pre-dose mycophenolic acid (MPA) levels were undetectable despite ensuring good adherence and increased MMF dose. Meanwhile, tacrolimus levels were on target. A pharmacokinetic study with area under concentration-time (AUC) evidenced absence of MPA levels after 4h from oral administration. Everolimus was introduced in substitution of MMF because of this, achieving adequate pre-dose concentration levels. After per-protocol intestine reconstruction with ileocolonic anastomosis, a new MPA pharmacokinetic curve was obtained. MPA dose adjusted AUC was 51% higher post correction. Concentration curves pre and post corrective surgery are presented (<b>figure 1</b>). <h3>Discusion</h3> MMF and its active metabolite MPA are rapidly absorbed resulting in a high oral bioavailability. Yet, because of enterohepatic circulation (EHC), a second rise in MPA plasmatic concentrations appears after 4-8h of its administration, contributing to 10-60% of the total AUC exposure. In patients with ileostomy, the lack of EHC causes a complete absence of MPA levels after 4h of oral administration and thus, an ulterior undetectable Cmin. <h3>Summary</h3> Patients with ileostomy and OHT may be at risk of rejection given the lack of EHC of MPM. Therapeutic monitoring of MPA with AUC or conversion to other immunosuppressants should be considered in this population." @default.
- W3136297246 created "2021-03-29" @default.
- W3136297246 creator A5000311423 @default.
- W3136297246 creator A5001919307 @default.
- W3136297246 creator A5003612995 @default.
- W3136297246 creator A5026330777 @default.
- W3136297246 creator A5042507458 @default.
- W3136297246 creator A5056857571 @default.
- W3136297246 creator A5062664613 @default.
- W3136297246 creator A5073706289 @default.
- W3136297246 creator A5076320939 @default.
- W3136297246 creator A5086792250 @default.
- W3136297246 date "2021-04-01" @default.
- W3136297246 modified "2023-10-18" @default.
- W3136297246 title "Impact of Colectomy with Ileostomy in Immunosuppression Management after Heart Transplantation Mycophenolate Mofetil Levels Secondary to Ileostomy" @default.
- W3136297246 doi "https://doi.org/10.1016/j.healun.2021.01.2012" @default.
- W3136297246 hasPublicationYear "2021" @default.
- W3136297246 type Work @default.
- W3136297246 sameAs 3136297246 @default.
- W3136297246 citedByCount "0" @default.
- W3136297246 crossrefType "journal-article" @default.
- W3136297246 hasAuthorship W3136297246A5000311423 @default.
- W3136297246 hasAuthorship W3136297246A5001919307 @default.
- W3136297246 hasAuthorship W3136297246A5003612995 @default.
- W3136297246 hasAuthorship W3136297246A5026330777 @default.
- W3136297246 hasAuthorship W3136297246A5042507458 @default.
- W3136297246 hasAuthorship W3136297246A5056857571 @default.
- W3136297246 hasAuthorship W3136297246A5062664613 @default.
- W3136297246 hasAuthorship W3136297246A5073706289 @default.
- W3136297246 hasAuthorship W3136297246A5076320939 @default.
- W3136297246 hasAuthorship W3136297246A5086792250 @default.
- W3136297246 hasBestOaLocation W31362972461 @default.
- W3136297246 hasConcept C112705442 @default.
- W3136297246 hasConcept C126322002 @default.
- W3136297246 hasConcept C126894567 @default.
- W3136297246 hasConcept C141071460 @default.
- W3136297246 hasConcept C2777056448 @default.
- W3136297246 hasConcept C2778033501 @default.
- W3136297246 hasConcept C2778720950 @default.
- W3136297246 hasConcept C2778773085 @default.
- W3136297246 hasConcept C2778849806 @default.
- W3136297246 hasConcept C2779699572 @default.
- W3136297246 hasConcept C2780252810 @default.
- W3136297246 hasConcept C2909675724 @default.
- W3136297246 hasConcept C2909935303 @default.
- W3136297246 hasConcept C2911091166 @default.
- W3136297246 hasConcept C71924100 @default.
- W3136297246 hasConcept C76318530 @default.
- W3136297246 hasConcept C90924648 @default.
- W3136297246 hasConcept C98274493 @default.
- W3136297246 hasConceptScore W3136297246C112705442 @default.
- W3136297246 hasConceptScore W3136297246C126322002 @default.
- W3136297246 hasConceptScore W3136297246C126894567 @default.
- W3136297246 hasConceptScore W3136297246C141071460 @default.
- W3136297246 hasConceptScore W3136297246C2777056448 @default.
- W3136297246 hasConceptScore W3136297246C2778033501 @default.
- W3136297246 hasConceptScore W3136297246C2778720950 @default.
- W3136297246 hasConceptScore W3136297246C2778773085 @default.
- W3136297246 hasConceptScore W3136297246C2778849806 @default.
- W3136297246 hasConceptScore W3136297246C2779699572 @default.
- W3136297246 hasConceptScore W3136297246C2780252810 @default.
- W3136297246 hasConceptScore W3136297246C2909675724 @default.
- W3136297246 hasConceptScore W3136297246C2909935303 @default.
- W3136297246 hasConceptScore W3136297246C2911091166 @default.
- W3136297246 hasConceptScore W3136297246C71924100 @default.
- W3136297246 hasConceptScore W3136297246C76318530 @default.
- W3136297246 hasConceptScore W3136297246C90924648 @default.
- W3136297246 hasConceptScore W3136297246C98274493 @default.
- W3136297246 hasIssue "4" @default.
- W3136297246 hasLocation W31362972461 @default.
- W3136297246 hasOpenAccess W3136297246 @default.
- W3136297246 hasPrimaryLocation W31362972461 @default.
- W3136297246 hasRelatedWork W1890838281 @default.
- W3136297246 hasRelatedWork W2011454096 @default.
- W3136297246 hasRelatedWork W2012450273 @default.
- W3136297246 hasRelatedWork W2041629314 @default.
- W3136297246 hasRelatedWork W2066892124 @default.
- W3136297246 hasRelatedWork W2113615533 @default.
- W3136297246 hasRelatedWork W2118272408 @default.
- W3136297246 hasRelatedWork W2323967556 @default.
- W3136297246 hasRelatedWork W2360902757 @default.
- W3136297246 hasRelatedWork W3136297246 @default.
- W3136297246 hasVolume "40" @default.
- W3136297246 isParatext "false" @default.
- W3136297246 isRetracted "false" @default.
- W3136297246 magId "3136297246" @default.
- W3136297246 workType "article" @default.