Modigraf administration through jejunostomy in liver transplant recipient: case report

Area of Science:

• Hepatology
• Transplantation Surgery
• Gastroenterology

Background:

• Liver transplantation is a complex procedure for end-stage liver disease.
• Alcoholic and hepatitis C cirrhosis are common indications for liver transplantation.
• Postoperative complications, such as esophageal perforation, can occur.

Observation:

• A 61-year-old patient with alcoholic and hepatitis C cirrhosis underwent liver transplantation.
• On postoperative day 3, the patient developed mediastinitis secondary to esophageal perforation from a Linton tube.
• An esophagectomy with jejunostomy was performed for management.

Findings:

• Tacrolimus granules for oral suspension (Modigraf) were administered via the jejunostomy.
• The administration route through jejunostomy was well-tolerated, with no observed secondary effects.
• Biochemical parameters remained within normal limits during the jejunostomy period.

Implications:

• This case highlights the feasibility of administering tacrolimus granules via jejunostomy in liver transplant recipients.
• The findings suggest that jejunostomy administration of Modigraf may not significantly impact bioavailability or cause adverse effects.
• Further investigation into tacrolimus jejunostomy administration strategies is warranted for complex surgical cases.