Living‒donor kidney transplantation in patient with ulcerative colitis receiving ongoing risankizumab therapy

Abstract

This report describes a case of living‒donor kidney transplantation involving a patient who was receiving ongoing risankizumab therapy for ulcerative colitis. The patient had a long history of ulcerative colitis and had undergone multiple treatments, with risankizumab initiated one‒year prior to transplantation, leading to stabilization of gastrointestinal symptoms. The progression of autosomal dominant polycystic kidney disease resulted in end‒stage renal failure, necessitating kidney transplantation. Postoperative immunosuppressive therapy consisted of tacrolimus, mycophenolate mofetil, and corticosteroids, with early introduction of everolimus and subsequent dose reduction of mycophenolate mofetil and tacrolimus to avoid excessive immunosuppression. The graft function promptly improved, and no infectious complications, rejection episodes, or wound‒related events were observed. To our knowledge, this is the first reported case of kidney transplantation performed while continuing risankizumab preoperatively, and appropriate adjustment of immunosuppressive therapy facilitated safe perioperative management.