Upper gastrointestinal complications after renal transplantation: a 3-yr sequential study

Area of Science:

• Nephrology
• Gastroenterology
• Transplant Surgery

Background:

• Upper GI complications pose significant risks for renal transplant recipients.
• Recent advancements include proton-pump inhibitors for antiulcer prophylaxis and tacrolimus-based immunosuppression.
• Limited data exists on foregut complications post-renal transplantation with these newer agents.

Purpose of the Study:

• To compare upper gastrointestinal complication rates in renal transplant patients.
• To evaluate omeprazole versus ranitidine for antiulcer prophylaxis.
• To assess tacrolimus versus cyclosporin-based immunosuppression regimens.

Main Methods:

• Prospective data collection from 236 renal transplant recipients (January 1996 - December 1998).
• Comparison of upper gastrointestinal complication frequencies based on antiulcer and immunosuppression therapies.
• Statistical analysis of complication rates and patient demographics.

Main Results:

• Overall, 8% of patients developed upper GI complications; opportunistic infections were most common (45%).
• No significant differences in complication rates were found between omeprazole and ranitidine groups (8% vs. 9%).
• No significant differences were observed between tacrolimus and cyclosporin groups (7% vs. 10%).
• Older patients and those with diabetes had higher complication rates, particularly opportunistic infections.

Conclusions:

• Renal transplantation is associated with a low frequency (8%) of upper GI complications.
• Tacrolimus and cyclosporin-based immunosuppression showed comparable complication rates.
• Omeprazole and ranitidine demonstrated equivalent efficacy for antiulcer prophylaxis in this patient population.