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Acute appendicitis after solid organ transplantation.

Aaron Savar1, Jonathan R Hiatt, Ronald W Busuttil

  • 1Department of Surgery, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7054, USA.

Clinical Transplantation
|March 25, 2006
PubMed
Summary
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Appendicitis is rare after solid organ transplants, but diagnosis and treatment are similar to the general population. Post-transplant appendicitis cases show higher complication rates and longer hospital stays.

Area of Science:

  • Transplantation Immunology
  • Gastroenterology
  • Surgical Pathology

Background:

  • Appendicitis is an uncommon complication following solid organ transplantation.
  • Previous reports of appendicitis after transplantation are rare, with none documented after liver transplantation.

Purpose of the Study:

  • To investigate the incidence, clinical presentation, and outcomes of appendicitis in solid organ transplant recipients.
  • To compare appendicitis in transplant recipients with the general population.

Main Methods:

  • Retrospective review of solid organ transplant recipients who underwent appendectomy between 1989 and 2002.
  • Analysis of patient demographics, transplant type, interval from transplant to appendectomy, symptoms, diagnostic methods (including CT scans), surgical approach, pathology, and outcomes.

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Main Results:

  • 17 out of nearly 8000 transplant recipients developed appendicitis.
  • Common symptoms included abdominal pain (94%), nausea/vomiting (88%), and leukocytosis (76%).
  • Computed tomography (CT) accurately diagnosed appendicitis in 15 of 16 patients. Complications occurred in 24% of patients, with longer hospitalizations compared to non-transplant patients.

Conclusions:

  • Appendicitis is a rare but significant complication after solid organ transplantation.
  • Clinical presentation is similar to non-transplant patients, but complications and hospitalization duration are increased.
  • CT imaging is valuable for prompt diagnosis in this population.