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Why people switch The most common reasons include weight loss plateaus, inadequate response at maximum dose, side effect intolerance, cost or insurance changes, and desire for greater efficacy

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Surgery should be deferred when shedding remains active, weight or nutrition is unstable, the diagnosis is uncertain, inflammatory or scarring disease is active, donor miniaturization is diffuse, expectations are unrealistic, or the patient believes transplantation will stop future shedding

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