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This process compensates for the lost absorptive surface area and involves mechanisms regulated by the ENS, such as blood flow, motility, secretory functions, and immune responses[143]

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Patients receiving gemcitabine should be monitored for signs and symptoms of TMA, such as oedema, hypertension, markers of haemolysis, thrombocytopaenia and proteinuria, in the appropriate clinical context 37,44