Colon perforation after renal transplantation: A single-institution review

J. Pirenne, E. Lledo-Garcia, E. Benedetti, M. West, N. S. Hakim, D. E.R. Sutherland, R. W.G. Gruessner, J. S. Najarian, A. J. Matas

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38 Scopus citations

Abstract

Colon perforation (CP) is an uncommon but dramatic complication after renal transplantation. Of 1530 consecutive kidney transplants performed at our center, 8 recipients had an CP (incidence of 0.5%), either early (n = 5, 2-14 days) or late (n = 3, 8-48 months) post transplant. Clinical symptoms were generally vague. Biological findings were inconstant. Risk factors for CP included a cadaver graft (versus a living donor), high body weight, history of diverticulitis, and Kayexalate use. Crucial to outcome were: 1) immediate diagnosis and 2) aggressive surgical care consisting of resectional therapy, broad-spectrum antibiotics, and reduced immunosuppression. Applying these principles, mortality in our patients (25%) was lower than in previously reported series (33-64%). All grafts were functioning at the time of diagnosis; graft function was preserved in recipients who recovered from CP. Patients with a documented history of diverticulitis should undergo prophylactic colonic resection. Constipation and colonic dilatation should be treated aggressively in the early post-operative period.

Original languageEnglish (US)
Pages (from-to)88-93
Number of pages6
JournalClinical Transplantation
Volume11
Issue number2
StatePublished - Apr 1997

Keywords

  • Colon perforation
  • Renal transplantation

ASJC Scopus subject areas

  • Transplantation

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    Pirenne, J., Lledo-Garcia, E., Benedetti, E., West, M., Hakim, N. S., Sutherland, D. E. R., Gruessner, R. W. G., Najarian, J. S., & Matas, A. J. (1997). Colon perforation after renal transplantation: A single-institution review. Clinical Transplantation, 11(2), 88-93.