Gastrointestinal complications after renal transplantation: predictive factors and morbidity
M. L. Owens, S. E. Wilson, R. Saltzman and H. E. Gordon
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.
