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Peptic ulceration in kidney transplantation
Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
|January 1, 1977
Summary
Gastrointestinal ulcers are a serious risk for transplant recipients, often leading to bleeding and perforation. Current preventive measures are insufficient, necessitating new strategies for managing this high-mortality complication.
Area of Science:
- Transplantation Medicine
- Gastroenterology
- Surgical Complications
Background:
- Gastroduodenal ulceration is a significant post-transplantation complication.
- This complication carries a high mortality rate (42%) and presents with bleeding and perforation.
- Ulcer development is frequently associated with acute rejection treatment.
Purpose of the Study:
- To highlight the inadequacy of current antacid-based prophylaxis for gastroduodenal ulceration in transplant patients.
- To explore alternative strategies for reducing ulcer incidence in this population.
- To emphasize the need for evaluating new prophylactic treatments, including histamine (H2) blocking agents.
Main Methods:
- Retrospective analysis of 500 transplantations in 434 patients.
- Observation of complication rates and outcomes.
- Discussion of potential prophylactic measures based on observed patient characteristics.
Main Results:
- 45 patients (9%) developed gastroduodenal ulceration post-transplantation.
- Mortality rate for this complication was 42%.
- Complications peaked during acute rejection treatment.
Conclusions:
- Current antacid prophylaxis is inadequate for preventing gastroduodenal ulceration in transplant recipients.
- Preoperative evaluation of gastric secretion and serum gastrin levels may inform prophylactic strategies.
- Histamine (H2) blocking agents warrant investigation as a potential prophylactic treatment.