“…For example, improvement in gastric motility can facilitate the absorption of immunosuppressants, such as tacrolimus, which in theory, could subsequently increase its bioavailability and result in toxicity requiring a dose reduction. 5 In refractory cases when dietary and medical therapy are unsuccessful, endoscopic and surgical procedures are available, such as the insertion of a feeding jejunostomy tube, 6, 7 the use of implantable gastric electrical stimulator devices, 8,9 or major surgical resection, such as partial or total gastrectomy. 10 We report the use of endoscopic botulinum toxin (Botox, Allergan, Inc., Irvine, CA, USA) injection in patients with symptomatic DGE secondary to diabetic gastroparesis, specifically in patients who have undergone or are awaiting either pancreas or islet-cell transplantation.…”