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Gastrointestinal Complications After Renal Transplantation: Predictive Factors and Morbidity

Gastrointestinal Complications After Renal Transplantation: Predictive Factors and Morbidity Abstract • In a ten-year study involving 109 renal transplant patients, 37 (34%) developed gastrointestinal complications. The immediate mortality from these complications was 27%. Three of four patients with erosive gastritis died. Five deaths occurred among 17 patients who developed ulcers after transplantation. Emergency surgery for ulcers resulted in two deaths. Patients with peptic ulcer disease, esophagitis, or bleeding before transplantation were much more likely to develop recurrences that patients not so affected. Peptic ulcer occurred notably more often in recipients whose kidneys came from cadavers than from related donors. Experience with gastrointestinal bleeding or its absence during a first transplant is a useful predictor of the results after a second transplant. The high recurrence rate and high mortality suggest that patients with ulcer disease demonstrated before kidney transplantation should either undergo elective surgery for ulcer disease or not be accepted for transplantation. Patients in whom ulcer disease develops after a kidney transplant shoud undergo early elective surgery. (Arch Surg 111:467-471, 1976) References 1. Evans DB, Smellie WAB: Complications , in Calne Y (ed): Clinical Organ Transplantation . Oxford, Blackwell Scientific Publications, 1971, pp 286-287. 2. Starzl TE: Experience in Renal Transplantation . Philadelphia, WB Saunders Co, 1964 p 115. 3. Moore TC, Hume DM: The period and nature of hazard in clinical renal transplantation . Ann Surg 170:1-12, 1969.Crossref 4. Penn I, Groth CG, Brettschneider J, et al: Surgically correctable intraabdominal complications before and after renal homotransplantation . Ann Surg 168:865-870, 1968.Crossref 5. Moghadam M, Gluckmann R, Eyler WR: The radiologic assessment of gastric output . Radiology 89:888-892, 1967.Crossref 6. Lewicki AM, Schozo S, Merrill JP: Gastrointestinal bleeding in the renal transplant patient . Radiology 102:533-537, 1972.Crossref 7. Weiner SN, Vertes V, Shapiro H: The upper gastrointestinal tract in patients undergoing chronic dialysis . Radiology 92:110-114, 1969.Crossref 8. Falcao HN, Wesdorp RTC, Fischer JE: Gastrin levels and gastric acid secretion in anephric patients and in patients with chronic and acute renal failure . J Surg Res 18:107-111, 1975.Crossref 9. Korman MG, Tover MC, Hansky J: Hypergastrinemia in chronic renal failure . Br Med J 1:209-210, 1972.Crossref 10. Grossman MI: Gastrointestinal hormones: A panoramic view. Read before the Endocrine Society, New York, June 20, 1975. 11. Aldrete JS, Sterling WA, Hathaway BM, et al: Gastrointestinal and hepatic complications affecting patients with renal allografts . Am J Surg 129:115-124, 1975.Crossref 12. Hadjiyannakis EJ, Evans DB, Smellie WAB, et al: Gastrointestinal complications after renal transplantation . Lancet 2:781-785, 1971.Crossref 13. Spanos PK, Simmons RJ, Rattazzi TC, et al: Peptic ulcer disease in the transplant recipient . Arch Surg 109:193-197, 1974.Crossref 14. Woods JE, Anderson CF, Johnson WJ, et al: Experience with renal transplantation in high risk patients . Surg Gynecol Obstet 137:393-398, 1973. 15. Shepherd AMM, Steward WK, Wormsley KG: Peptic ulceration in chronic renal failure . Lancet 1:1357-1359, 1973.Crossref 16. Gordon EM, Johnson AG, Williams G: Gastric assessment of prospective renal transplant patients . Lancet 1:226-229, 1972.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Gastrointestinal Complications After Renal Transplantation: Predictive Factors and Morbidity

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1976.01360220163027
Publisher site
See Article on Publisher Site

Abstract

Abstract • In a ten-year study involving 109 renal transplant patients, 37 (34%) developed gastrointestinal complications. The immediate mortality from these complications was 27%. Three of four patients with erosive gastritis died. Five deaths occurred among 17 patients who developed ulcers after transplantation. Emergency surgery for ulcers resulted in two deaths. Patients with peptic ulcer disease, esophagitis, or bleeding before transplantation were much more likely to develop recurrences that patients not so affected. Peptic ulcer occurred notably more often in recipients whose kidneys came from cadavers than from related donors. Experience with gastrointestinal bleeding or its absence during a first transplant is a useful predictor of the results after a second transplant. The high recurrence rate and high mortality suggest that patients with ulcer disease demonstrated before kidney transplantation should either undergo elective surgery for ulcer disease or not be accepted for transplantation. Patients in whom ulcer disease develops after a kidney transplant shoud undergo early elective surgery. (Arch Surg 111:467-471, 1976) References 1. Evans DB, Smellie WAB: Complications , in Calne Y (ed): Clinical Organ Transplantation . Oxford, Blackwell Scientific Publications, 1971, pp 286-287. 2. Starzl TE: Experience in Renal Transplantation . Philadelphia, WB Saunders Co, 1964 p 115. 3. Moore TC, Hume DM: The period and nature of hazard in clinical renal transplantation . Ann Surg 170:1-12, 1969.Crossref 4. Penn I, Groth CG, Brettschneider J, et al: Surgically correctable intraabdominal complications before and after renal homotransplantation . Ann Surg 168:865-870, 1968.Crossref 5. Moghadam M, Gluckmann R, Eyler WR: The radiologic assessment of gastric output . Radiology 89:888-892, 1967.Crossref 6. Lewicki AM, Schozo S, Merrill JP: Gastrointestinal bleeding in the renal transplant patient . Radiology 102:533-537, 1972.Crossref 7. Weiner SN, Vertes V, Shapiro H: The upper gastrointestinal tract in patients undergoing chronic dialysis . Radiology 92:110-114, 1969.Crossref 8. Falcao HN, Wesdorp RTC, Fischer JE: Gastrin levels and gastric acid secretion in anephric patients and in patients with chronic and acute renal failure . J Surg Res 18:107-111, 1975.Crossref 9. Korman MG, Tover MC, Hansky J: Hypergastrinemia in chronic renal failure . Br Med J 1:209-210, 1972.Crossref 10. Grossman MI: Gastrointestinal hormones: A panoramic view. Read before the Endocrine Society, New York, June 20, 1975. 11. Aldrete JS, Sterling WA, Hathaway BM, et al: Gastrointestinal and hepatic complications affecting patients with renal allografts . Am J Surg 129:115-124, 1975.Crossref 12. Hadjiyannakis EJ, Evans DB, Smellie WAB, et al: Gastrointestinal complications after renal transplantation . Lancet 2:781-785, 1971.Crossref 13. Spanos PK, Simmons RJ, Rattazzi TC, et al: Peptic ulcer disease in the transplant recipient . Arch Surg 109:193-197, 1974.Crossref 14. Woods JE, Anderson CF, Johnson WJ, et al: Experience with renal transplantation in high risk patients . Surg Gynecol Obstet 137:393-398, 1973. 15. Shepherd AMM, Steward WK, Wormsley KG: Peptic ulceration in chronic renal failure . Lancet 1:1357-1359, 1973.Crossref 16. Gordon EM, Johnson AG, Williams G: Gastric assessment of prospective renal transplant patients . Lancet 1:226-229, 1972.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1976

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