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Incidence, Management, and Risk Factors for Lower Gastrointestinal Bleeding in Renal Transplant Recipients
A Rencuzogullari1, S Binboga1, E Aytac1
1Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, United States.
Transplantation Proceedings
|March 26, 2017
Summary
Lower gastrointestinal bleeding (LGB) affects 2.9% of renal transplant recipients (RTR). Nonfunctioning transplanted kidneys increase LGB risk and overall mortality in RTR, highlighting the need to preserve kidney function.
Area of Science:
- Nephrology
- Gastroenterology
- Transplantation Medicine
Background:
- Limited data exist on managing lower gastrointestinal bleeding (LGB) in renal transplant recipients (RTR).
- Understanding LGB incidence, management, and risk factors in RTR is crucial.
Purpose of the Study:
- To evaluate the incidence, management strategies, and risk factors of LGB in RTR.
- To identify factors associated with LGB in renal transplant recipients.
Main Methods:
- Retrospective analysis of renal transplant recipients (RTR) with lower gastrointestinal bleeding (LGB) between January 2004 and December 2013.
- LGB defined as hemorrhage after excluding upper gastrointestinal causes.
Main Results:
- 2.9% (45/1578) of RTR experienced LGB, most commonly due to colitis and angiodysplasia.
- Nonfunctioning kidneys post-transplant were a significant risk factor for LGB (P < .0001).
- RTR with LGB had increased overall mortality (P = .001) but no increased risk from anticoagulants/antiplatelets.
Conclusions:
- Nonfunctioning transplanted kidneys are a risk factor for LGB in RTR.
- LGB is associated with increased overall mortality in renal transplant recipients.
- Strategies to prolong transplanted kidney function may reduce LGB incidence and improve survival in RTR.
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