PMID- 32029315
OWN - NLM
STAT- MEDLINE
DCOM- 20200805
LR  - 20211204
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 52
IP  - 2
DP  - 2020 Mar
TI  - Spontaneous Chylous Ascites After Liver Transplantation Secondary to Everolimus: 
      A Case Report.
PG  - 638-640
LID - S0041-1345(19)31290-4 [pii]
LID - 10.1016/j.transproceed.2019.10.036 [doi]
AB  - Chylous ascites (CA) is an uncommon entity with several etiologies. Only a few 
      cases of CA have been reported as a complication after liver transplantation 
      (LT). Most of these cases occurred within 1 month after surgery and typically 
      resulted from traumatic intraoperative injury leading to disruption of 
      lymphatics. Although peripheral lymphedema has been frequently correlated with 
      use of calcineurin inhibitors, associated spontaneous CA has only been reported 
      in a few cases after renal transplantation. We report a case of delayed 
      spontaneous CA after LT caused by the use of the mammalian target of rapamycin 
      (mTOR) inhibitor everolimus. Everolimus was introduced in our patient early after 
      transplantation because of tacrolimus-induced microangiopathy, and years later 
      the patient presented with spontaneous CA. After excluding other causes of CA, 
      everolimus was discontinued, and immunosuppression was maintained by increasing 
      prednisone and continuing mycophenolate mofetil. Additionally, the patient was 
      treated with percutaneous drain placement and began a low-fat, high-protein diet. 
      One month later the patient had complete resolution of symptoms with no 
      recurrence of ascites. To our knowledge, this is the first case of delayed-onset 
      CA caused by everolimus after LT.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Saucedo-Crespo, Hector
AU  - Saucedo-Crespo H
AD  - Avera McKennan Hospital & University Health Center, Avera Medical Group 
      Transplant and Liver Surgery, Sioux Falls, South Dakota; Department of Surgery, 
      University of South Dakota, Sanford School of Medicine, Sioux Falls, South 
      Dakota. Electronic address: Hector.Crespo@usd.edu.
FAU - Roach, Eric
AU  - Roach E
AD  - University of South Dakota, Sanford School of Medicine, Sioux Falls, South 
      Dakota.
FAU - Sakpal, Sujit Vijay
AU  - Sakpal SV
AD  - Avera McKennan Hospital & University Health Center, Avera Medical Group 
      Transplant and Liver Surgery, Sioux Falls, South Dakota; Department of Surgery, 
      University of South Dakota, Sanford School of Medicine, Sioux Falls, South 
      Dakota; Department of Internal Medicine, University of South Dakota, Sanford 
      School of Medicine, Sioux Falls, South Dakota.
FAU - Auvenshine, Christopher
AU  - Auvenshine C
AD  - Avera McKennan Hospital & University Health Center, Avera Medical Group 
      Transplant and Liver Surgery, Sioux Falls, South Dakota; Department of Surgery, 
      University of South Dakota, Sanford School of Medicine, Sioux Falls, South 
      Dakota.
FAU - Steers, Jeffery
AU  - Steers J
AD  - Avera McKennan Hospital & University Health Center, Avera Medical Group 
      Transplant and Liver Surgery, Sioux Falls, South Dakota.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200203
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Immunosuppressive Agents)
RN  - 9HW64Q8G6G (Everolimus)
SB  - IM
MH  - Chylous Ascites/*chemically induced
MH  - Everolimus/*adverse effects
MH  - Humans
MH  - Immunosuppression Therapy/methods
MH  - Immunosuppressive Agents/*adverse effects
MH  - *Liver Transplantation
MH  - Middle Aged
EDAT- 2020/02/08 06:00
MHDA- 2020/08/06 06:00
CRDT- 2020/02/08 06:00
PHST- 2019/09/15 00:00 [received]
PHST- 2019/10/06 00:00 [accepted]
PHST- 2020/02/08 06:00 [pubmed]
PHST- 2020/08/06 06:00 [medline]
PHST- 2020/02/08 06:00 [entrez]
AID - S0041-1345(19)31290-4 [pii]
AID - 10.1016/j.transproceed.2019.10.036 [doi]
PST - ppublish
SO  - Transplant Proc. 2020 Mar;52(2):638-640. doi: 10.1016/j.transproceed.2019.10.036. 
      Epub 2020 Feb 3.