Abdominal Complications After Lung Transplantation in a Brazilian Single Center (original) (raw)
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Morbidity and mortality of serious gastrointestinal complications after lung transplantation
Journal of Cardiothoracic Surgery, 2019
Background Gastrointestinal complications after lung transplatation are associated with an increased risk of morbidity and mortality. This study aims to describe severe gastrointestinal complications (SGC) after lung transplantation. Methods We performed a prospective, observational study that included 136 lung transplant patients during a seven year period in a tertiary care universitary hospital. SGC were defined as any diagnosis related to the gastrointestinal or biliary tract leading to lower survival rates or an invasive therapeutic procedure. Early and late complications were defined as those occurring < 30 days and ≥ 30 days post-transplant. The survival function was calculated through the Kaplan-Meier estimator. Variables were analyzed using univariate and multivariate analysis. Statistical significance was defined as p < 0.05. Results There were 17 (12.5%) SGC in 17 patients. Five were defined as early. Twelve patients (70.6%) required surgical treatment. Mortality wa...
Gastrointestinal Complications After Lung Transplantation
The Journal of Heart and Lung Transplantation, 2009
Background: Gastrointestinal complications after lung transplantation remain a common yet poorly defined problem. In this study we examine our experience with gastrointestinal complications after lung transplantation.
Gastroparesis After Lung Transplantation
Chest, 1995
We observed an unexpectedly high inci¬ dence of postoperative gastroparesis among lung and heart-lung transplant recipients. Purpose: To identify the incidence of GI complications and to describe the clinical profiles of patients who developed symptomatic gastroparesis after lung trans¬ plantation. Patients and methods: Retrospective study ofGI symp¬ toms and complications identified during 3 years of follow-up of 38 adult lung and heart-lung transplant recipients. Results: Sixteen of 38 patients (42%) reported one or more GI complaint and received a specific GI diagno¬ sis. Nine of 38 patients (24%) complained of early sa¬ tiety, epigastric fullness, anorexia, nausea, or vomiting. Gastroparesis was suspected when endoscopic evalu¬ ation revealed undigested food in the stomach after overnight fast and symptoms could not be attributed to peptic disease or cytomegalovirus gastritis. Delayed gastric emptying was confirmed by gastric scintigra¬ phy. Mean gastric emptying (tM) was 263 ±115 min (normal <95 min). Gastroparesis occurred in 4 of 13 right lung, 2 of 12 left lung, 1 of 9 bilateral single lung, and 2 of 4 heart-lung recipients (p=NS). Patients responded partially to metoclopramide or cisapride, with the exception of two patients who required placement of jejunalfeeding tubes secondary to severe symptoms. In long-term follow-up, symptoms resolved in all patients and treatment with medications or me¬ chanical intervention was successfully discontinued. Four ofnine patients (44%) suffering from gastropare¬ sis developed obliterative bronchiolitis (OB). Food particles were discovered in the BAL fluid of two such symptomatic patients. In contrast, only 6 of 29 (21%) nonsymptomatic patients developed OB (p=0.16). Conclusion: Symptomatic gastroparesis is a frequent complication of lung or heart-lung transplantation that may promote microaspiration into the lung allograft. (CHEST 1995; 108:1602-07) CMV=cytomegalovirus; OB=obliterative bronchiolitis; t^=mean gastric emptying Key words: bronchiolitis obliterans; gastric stasis; immun¬ osuppression lO ecipients of solid organ transplants often complain .***-of diverse abdominal symptoms that may develop from stress, intercurrent infections, or medications. The frequency of GI complaints after transplantation is variable, but may approach 35% in heart-lung transplant recipients.1 Most GI symptoms are associ¬ ated with peptic ulcer disease, cytomegalovirus (CMV) gastritis, and pancreatitis, but rarer symptoms and Clinical Investigations
Gastrointestinal Complications in Heart Transplant Patients: MITOS Study
Transplantation Proceedings, 2007
Introduction. The most frequent immunosuppressive treatment complications in solid organ transplant recipients are gastrointestinal (GI) disorders. Materials and Methods. An observational, cross-sectional study to evaluate the prevalence and management of GI complications in transplanted patients was conducted via a written questionnaire given to doctors at their practice.
Emergency abdominal surgery after solid organ transplantation: a systematic review
World journal of emergency surgery : WJES, 2016
Due to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems. The literature search was performed on online databases with the time limit 1990-2015. Studies describing all types of emergency abdominal surgery in solid organ transplanted patients were retrieved for evaluation. Thirty-nine case series published between 1996 and 2015 met the inclusion criteria and were selected for the systematic review. Overall, they included 71671 transplanted patients, of which 1761 (2.5 %) underwent emergency abdominal surgery. The transplanted organs were the heart in 65.8 % of patients, the lung in 22.1 %, the kidney in 9.5 %, and the liver in 2.6 %. The mean patients' age at the time of the...
Acute diverticulitis in heart- and lung transplant patients
Transplant International, 2001
Significant gastrointestinal complications have been observed in patients following heartand lung transplantation. These complications can occur in the immediate post-operative period or remote from the time of transplantation. We retrospectively reviewed the medical records of 268 consecutive patients who received either heart-or lung transplants at Henry Ford Hospital between 1985 and 1998. Two hundred and thirty-three patients received heart transplants and 35 underwent lung transplantation. Two patients developed acute
Postoperative surgical complications after lung transplantation
Revista Portuguesa de Pneumologia (English Edition), 2015
This is a review article on the main postoperative complications after lung transplantation: airways complications, vascular complications, pleural complications, surgical wound complications, and abdominal complications. Incidence data, severity, and major management regimens are reported. Postoperative complications after lung transplantation result in a significantly increased morbidity and mortality, with early diagnosis and therapy being extremely important.
European Journal of Cardio-Thoracic Surgery, 2002
Objectives: Cardiac disease is a common cause of mortality and morbidity in patients with abdominal solid organ transplant. Improvement of the results of abdominal organ transplantation has contributed to an increasing pool of patients who require open heart surgery. We investigated short-and long-term results of open heart surgery in patients with functioning abdominal solid organ transplants. Methods: We retrospectively examined 60 patients (52.5 years in average) undergoing coronary artery bypass grafting and/or valve surgery since July 1988 after abdominal organ transplantation. There were 22 females (37%). They consisted of 46 kidney, nine kidney-pancreas and five liver recipients. Cardiac surgery was performed 68.9 months after transplantation. Preoperative serum creatinine level was 2.1 mg/dl, and 11 patients (18%) had creatinine level more than 3.0 mg/dl. Eleven patients (18%) were operated upon on non-elective basis. Twelve patients (20%) were not given stress-dose steroids postoperatively. Results: Three patients died early after surgery (5.0%). Twenty-six major complications were seen in 17 patients (28%), including deterioration of renal function in seven (three patients required temporary hemodialysis), three major infections, two bleeding complications, and two strokes. No graft loss was encountered. No differences were seen in mortality and morbidity between patients with or without stress-dose steroids. Multivariate analysis identified cardiopulmonary bypass time (P , 0:05) as a risk factor for operative death, preoperative creatinine level (P , 0:05), cardiopulmonary bypass time (P , 0:05) and the amount of fresh frozen plasma used (P , 0:05) for major complication, non-elective surgery (P , 0:01) for deterioration of renal function. Thirteen patients died and five kidney allografts failed late after surgery. Three-and 5-year patient and graft survivals were 70.8 and 66.8, 84.5 and 84.5%, respectively. Multivariate regression analysis identified female gender (P , 0:05), body mass index (P , 0:001) and non-elective surgery (P , 0:001) as risk factors for late death, and preoperative creatinine level (P , 0:05) for late graft loss. Conclusions: Open heart surgery can be performed with acceptable short-and long-term results in patients with functioning abdominal transplants. Stress-dose steroid may be unnecessary in selected patients. Aggressive use of open heart surgery in this patient population to avoid non-elective surgery may further improve early and late surgical outcomes. q