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[Preventive gastrectomies before kidney transplantations].

M M Linder, J F Bussmann, W Kösters

    Fortschritte Der Medizin
    |November 17, 1977
    PubMed
    Summary

    Prophylactic gastric surgery in renal transplant candidates with gastroduodenal risk factors showed no serious complications or deaths. This approach may reduce the high mortality associated with gastroduodenal bleeding or perforation in these patients.

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    Recurrent acute pancreatitis and intraluminal duodenal diverticulum.

    Pancreas·1992

    Area of Science:

    • Nephrology
    • Gastroenterology
    • Surgical Oncology

    Background:

    • Gastroduodenal bleeding or perforation is a serious complication in renal transplant patients, with high mortality rates.
    • Identifying patients at risk for gastroduodenal complications is crucial for effective management.
    • Chronic hemodialysis patients awaiting renal transplantation represent a population where prophylactic measures may be beneficial.

    Purpose of the Study:

    • To evaluate the safety and efficacy of prophylactic gastric surgery in renal transplant candidates with identified gastroduodenal risk factors.
    • To assess the outcomes of different surgical procedures in managing high-risk and low-risk patients.

    Main Methods:

    • A retrospective review of 61 patients undergoing chronic hemodialysis and preparation for renal transplantation since 1974.
    • Identification of gastroduodenal risk factors including history, ulcer disease, or hyperchlorhydria.
    • Surgical intervention in 20 patients with identified risk factors, categorized into high-risk (selective gastric vagotomy + hemigastrectomy) and low-risk (selective proximal vagotomy or truncal vagotomy + drainage) groups.

    Main Results:

    • No serious postoperative complications were observed in patients who underwent prophylactic gastric surgery.
    • No mortality was recorded in the surgically treated group.
    • The study included 12 high-risk and 8 low-risk patients who received specific surgical interventions.

    Conclusions:

    • Prophylactic gastric surgery appears to be a safe and effective strategy in renal transplant candidates with gastroduodenal risk factors.
    • This surgical approach may mitigate the risk of severe gastroduodenal complications and associated mortality in this vulnerable patient population.
    • Further research could explore long-term outcomes and cost-effectiveness of this prophylactic measure.

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