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Intestinal ischemia.

Simpson L Dee1, Khalid Butt, Gita Ramaswamy

  • 1Department of Pathology, New York Medical College, Westchester Medical Center, Valhalla, USA. sldee1@pol.net

Archives of Pathology & Laboratory Medicine
|September 26, 2002
PubMed
Summary

Post-transplant intestinal ischemia is a serious risk, particularly in older recipients of cadaveric kidneys. Early recognition of abdominal symptoms is crucial for improving outcomes in renal transplant patients.

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Transplantation Surgery

Background:

  • Gastrointestinal complications are increasingly significant in renal transplantation.
  • Ischemic colitis and colonic perforation are common, leading to morbidity and mortality.

Purpose of the Study:

  • Identify risk factors for intestinal ischemia in renal transplant recipients.
  • Define circumstances influencing this risk.

Main Methods:

  • Retrospective study of 356 renal transplant patients over 40 months.
  • Review of medical records, pathology reports, and autopsy findings.

Main Results:

  • 11 patients (3.1%) developed bowel ischemia within 20 days post-transplant; 6 died.
  • Most affected patients received cadaveric kidneys and were over 40.
  • Terminal ileum and ascending colon were most frequently involved.

Conclusions:

  • Post-transplant intestinal ischemia is multifactorial.
  • Emphasize risk in older recipients of cadaveric kidneys presenting with abdominal symptoms.
  • Early detection and management are critical.

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