Dose-adjusted cyclosporine c2 in a XXXX with jejunoileal bypass as compared to seven other liver transplant recipients.

@entity1 @entity5509 @entity2380 @entity870 @entity205 @entity6741
@entity5509 ( @entity5509 ) is a weight loss procedure in which malabsorption is produced by connecting a short length of proximal jejunum to the distal ileum. Because 90% of the small intestine is bypassed, it may have impact on the dose-concentration response of oral @entity205 ( @entity870 ). The authors characterized the dose-adjusted blood concentrations of @entity870 obtained 2 hours (C2) after oral microemulsion @entity870 (ME- @entity870 ) in a liver transplant (LTx) subject with an intact @entity5509 , as compared with those from seven LTx controls without @entity5509 . The biliary reconstruction involved choledochocholedochostomy without external drainage in all @entity1 . ME- @entity870 was administered via a nasogastric tube within 24 hours after graft reperfusion. Oral @entity2380 was given prophylactically to the study subject only for 6 days after LTx. During the first week after LTx, the dose-adjusted C2 (mean +/- SD) for the study subject and for controls was 53 +/- 10 and 106 +/- 47 ng/mL, respectively (P < 0.001). The corresponding value during the period from day 7 to day 107 was 105 +/- 40 and 257 +/- 86 ng/mL, respectively (P < 0.001). Multiple linear regression revealed that dosage, days after LTx, and the presence of a @entity5509 were all independent predictors of C2 (R2 = 0.798, P = 0.037). Lack of bile resulting in malabsorption of ME- @entity870 was not thought to be significant contributor to her low dose-adjusted C2 because there was no external bile drainage and a portion of terminal ileum, where most @entity6741 reabsorption occurred, was still available after @entity5509 . The fact that @entity2380 failed to increase the dose-adjusted C2 in the study subject supports that enteric clearance of @entity870 may become clinically unimportant after @entity5509 . Therefore, the low dose-adjusted C2 is most likely explained by the reduced bowel length and associated absorptive surface area after @entity5509 . In conclusion, @entity1 with @entity5509 may require higher doses of ME- @entity870 .
