The spectrum of colonic complications in a lung transplant population

Abdominal complications are recognized as a common complication of solid organ transplantation. These complications can range from gastritis with minor morbidity to viscus perforation and death. This study addresses specifically colonic complications in lung transplant patients to highlight their high incidence and significant morbidity and mortality in this population.

Data was obtained from a prospectively gathered database on 210 patients who underwent isolated lung transplantation between February 1, 1990, and July 10, 2000 at the Cleveland Clinic Foundation. Chronic diarrhea without a specific colonic lesion and infectious diarrheas except for CMV disease was excluded from the analysis.

Twenty-seven of the 210 transplant recipients (13 percent) developed a colonic complication. The sex distribution of complications was 14 males and 13 females. The colonic complications noted were diverticulitis (9), CMV colitis (5), colon cancer/precancerous polyps (4), post transplant lymphoproliferative disorder (4), megacolon (4), colon rupture (2). One patient had concurrent CMV colitis and diverticulitis. Documented perforations occurred in seven patients and surgical resection was required in 11 patients. Of the 27 patients, 10 died and nine of the deaths were directly attributable to the colonic complication.

Colonic complications are common post lung transplant and result in excessive morbidity and mortality in this population. Strategies to reduce this risk should be put in place in lung transplant centers.