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Steven W. Merrell, MD; Scott A. Ames, MD; Edward W. Nelson, MD; Dale G. Renlund, MD; Shreekanth V. Karwande, MD; Nelson A. Burton, MD; John J. Sullivan, PhD; Kent W. Jones, MD; William A. Gay, Jr, MD

Arch Surg. 1989;124(8):889-894.

Abstract
• Serious complications involving the alimentary tract are commonly reported following cardiac transplantation, and may be associated with significant morbidity and mortality. The aim of this report was to review the incidence, severity, and outcome of abdominal complications in our heart transplant population in whom we used corticosteroid-sparing protocols for immunosuppression. From March 1985 through September 1988, 178 patients underwent 185 cardiac transplants. Twenty-six cardiac transplant recipients (15%) sustained 33 major abdominal complications, including gastrointestinal bleeding (n = 8), pancreatitis (n = 8), bowel perforation (n = 6), cholecystitis (n = 4), and miscellaneous other problems (n=7). Operative therapy was required in 61% of cases. No deaths were caused by the gastrointestinal complications or their operative management. Corticosteroid-sparing immunosuppression may be responsible for the low incidence of abdominal morbidity, and early, aggressive surgical intervention may reduce subsequent mortality.

(Arch Surg. 1989;124:889-894)

Author Affiliations
Utah Transplantation Affiliated Hospitals Cardiac Transplant Program

From the Department of Surgery and the Division of Cardiology, University of Utah College of Medicine, Salt Lake City.

Footnotes
Accepted for publication April 19, 1989.

Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 15, 1988.

Reprint requests to Department of Surgery, University of Utah College of Medicine, 50 North Medical Dr, Salt Lake City, UT 84132 (Dr Nelson).

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