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Gastric bezoar after hepatic transplantation
S J Schwarzenberg1, D K Freese, W D Payne
1Department of Pediatrics, University of Minnesota, Minneapolis 55455.
Journal of Pediatric Gastroenterology and Nutrition
|July 1, 1989
Summary
Gastric bezoars complicated liver transplant recovery in children. Olive oil used to dissolve cyclosporine (CSA) may contribute to bezoar formation and erratic drug absorption.
Area of Science:
- Pediatric surgery
- Transplantation immunology
- Gastroenterology
Background:
- Hepatic transplantation in children requires immunosuppression, often with cyclosporine (CSA).
- Cyclosporine (CSA) administration can involve large volumes of oil-based solvents.
- Gastric bezoars are masses of indigestible material that can cause gastrointestinal issues.
Observation:
- Three pediatric patients developed gastric bezoars post-hepatic transplantation.
- Two of these patients exhibited highly variable absorption of their cyclosporine (CSA) medication.
Findings:
- Post-transplant gastric bezoars can complicate recovery in children.
- Erratic cyclosporine (CSA) absorption was noted in patients with gastric bezoars.
- High-volume olive oil, used to solubilize CSA, is a potential contributing factor to bezoar formation.
Implications:
- Clinicians should consider bezoar formation as a complication in pediatric liver transplant recipients.
- Investigate alternative methods for CSA delivery or management of oil-based solvents.
- Optimize immunosuppression monitoring in post-transplant patients with gastrointestinal complications.