Severe Abdominal Complications in Lung Transplant Recipients

Lung transplant is a complex procedure with potential for substantial postoperative complications, including abdominal issues. Although previous studies have suggested that preexisting gastrointestinal conditions may be associated with a high risk of posttransplant complications, the evidence remains inconsistent. We aimed to explore the incidence rates, risk factors, and outcomes of abdominal complications within the first year following lung transplant.

We conducted a retrospective cohort study at the University Hospital Zurich of 68 lung transplant recipients who experienced abdominal complications within 1 year after transplant. Data were collected from medical records on baseline demographic and clinical characteristics, including pretransplant gastrointestinal and hepatobiliary diseases. We used descriptive statistics (Fisher exact test, chi-square test, and Cramer V test) to assess outcome details, such as the timing and type of abdominal complications, surgical interventions, and associations with pretransplant conditions.

Abdominal complications occurred at a mean of 43 days posttransplant, with bowel ischemia and perforation as the most common reasons for posttransplant surgical intervention. Symptoms leading to surgery included nausea and abdominal pain, and 1 of 8 patients with abdominal surgery (12.5%) died after surgery. Notably, no significant associations were found between pretransplant factors (ie, gastrointestinal disease, hepatobiliary disease, body mass index >24, smoking status, peripheral vascular disease, and diabetes) and the occurrence of posttransplant abdominal surgery. Effect size analyses indicated very weak associations, suggesting that these pretransplant conditions are not strong predictors of postoperative abdominal complications.

Our results showed that preexisting gastrointestinal and hepatobiliary conditions, along with other common pretransplant factors, were not significant predictors of abdominal complications following lung transplant. Future studies should focus on intraoperative and immediate postoperative factors and should explore the role of minimally invasive surgical techniques and potential benefits of earlier or more comprehensive pretransplant screening.