Maintenance treatment with infliximab for ulcerative ileitis after intestinal transplantation: A case report

Table 1 Summary of the literature related to treatment with infliximab for ulcerative lesion after intestinal transplantation

Ref.	Number of patients	Age of the patients at the time of events (yr)	Disease	Baseline immunosuppressive therapy at the time of the event	Indications	Serum TNF-α (pg/mL)	Dose	Number of infusions	Interval after ITx	Outcome	Adverse events and F/u
Fishbein et al[17], 2006	4	N/A	N/A	N/A	Late-onset resistant rejection (no details available)	N/A	N/A	N/A	N/A	Full recovery	N/A
Giovanelli et al[18], 2008	1	11 (m)	Chronic intestinal pseudo-obstruction	Tacrolimus, sirolimus	Steroid-resistant ACR	N/A	N/A	1	18 mo	No response, remission after OKT3 treatment	EBV viremia, graft loss due to chronic rejection in 5 mo
Gerlach et al[19], 2011	9	27-44 (7: m 2: f)	Short bowel syndrome, chronic intestinal pseudo-obstruction	Steroid, tacrolimus, ATG, daclizumab, alemtuzumab, sirolimus, MMF	Late-onset OKT3-resistant ACR (2), early-onset OKT3-resistant ACR, humoral rejection (1), early-onset OKT3-resistant ACR (1), steroid-resistant ACR (3), chronic ulcerative ileitis/anastomositis (2)	Late-onset OKT3-resistant ACR (60-170), steroid-resistant ACR (80-140), chronic ulcerative ileitis (60-114), early-onset OKT3-resistant rejection (100-167)	5 mg/kg	12 ± 11.3	0-40 mo (18.2 + 14.1 mo)	6/9 sustained remission, 2/9 repeated transient remission, 1/9 graft loss	EBV infection (3), cutaneous mycosis, pneumonia, 6 mo to 10 yr
De Greef et al[20], 2012	2	13 (m), 5 (f)	Microvillous inclusion disease, short bowel syndrome	Tacrolimus monotherapy, rapamycin + daclizumab + steroid	Steroid- and ATG-resistant ACR	N/A	5 mg/kg, 4 mg/kg + 3 mg/kg 2-wk interval	1, 3	5 yr and 6 mo	Complete remission	27/22 mo
Avsar et al[21], 2014	1	52 (f)	Short bowel syndrome	Steroid, tacrolimus, everolimus, daclizumab, MMF	Graft rejection after CMV infection	N/A	5 mg/kg	1	6 mo	No response, graft explantation (no ATG)	Graft loss
Rao et al[22], 2016	1	38 (f)	Crohn’s disease	Steroid, tacrolimus	Late-onset steroid- and ATG-resistant ACR	N/A	Adalimumab	< 2	10 mo	Remission with maintenance adalimumab treatment	6 mo
Narang et al[23], 2019	1	20 (f)	Total intestinal aganglionosis + solitary kidney	Steroid, tacrolimus	Late-onset steroid-resistant ACR (moderate to severe), ulcerative ileitis	N/A	5 mg/kg, 10 mg/kg	More than 3	13 yr	No response with 5 mg/kg, remission after ATG, 10 mg/kg induced remission for another ACR episode later	PTLD (remission), 2 yr
Current case, 2020	1	20 (m)	Isolated hypoganglionosis	Tacrolimus	Chronic ulcerative ileitis, anastomositis	14.8-246 pg/mL	5-7.5 mg/kg	> 17	6 yr	Repeated transient remission	5 yr

TNF-α: Tissue necrosis factor alpha; ITx: Intestinal transplantation; ACR: Acute cellular rejection; OKT3: Anti-CD3 monoclonal antibody; EBV: Epstein-Barr virus; ATG: Anti-thymocyte globulin; MMF: Mycophenolate mofetil; CMV: Cytomegalovirus; PTLD: Posttransplant lymphoproliferative disorder; N/A: Not available.