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Complicated diverticulitis following renal transplantation
E D Lederman1, D J Conti, N Lempert
1Department of Surgery, Albany Medical College, New York, USA.
Diseases of the Colon and Rectum
|May 21, 1998
Summary
Complicated diverticulitis after kidney transplant is rare but can be atypical. Patients with polycystic kidney disease have a higher risk and require vigilant monitoring for abdominal symptoms.
Area of Science:
- Nephrology
- Gastroenterology
- Transplant Surgery
Background:
- Colonic perforations in renal transplant recipients historically carried high mortality.
- Previous series predated modern immunosuppressive protocols like cyclosporine.
Purpose of the Study:
- To evaluate the incidence and characteristics of complicated diverticulitis in renal transplant recipients.
- To identify risk factors associated with this complication.
Main Methods:
- Retrospective review of renal transplant patients who developed complicated diverticulitis.
- Analysis of factors including time since transplant, immunosuppression (cyclosporine), donor type, and renal failure cause.
Main Results:
- 13 (1.1%) patients developed complicated diverticulitis between 25 days and 14 years post-transplant.
- Polycystic kidney disease patients had a significantly higher rate (46% of cases, P < 0.001).
- Cyclosporine use and donor source did not significantly affect complication rates.
Conclusions:
- Complicated diverticulitis is rare in transplant recipients, with potentially atypical presentations.
- Polycystic kidney disease is a significant risk factor, necessitating aggressive evaluation of abdominal symptoms.
- Pretransplant screening and prophylactic surgery for high-risk patients warrant further investigation.