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http://dx.doi.org/10.5090/kjtcs.2010.43.3.280

Gastrointestinal Complications after Lung Transplantation  

Haam, Seok-Jin (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
Paik, Hyo-Chae (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
Kim, Ji-Hyun (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
Lee, Doo-Yun (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
Kim, Chang-Wan (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
Kim, Jung-Hwan (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
Publication Information
Journal of Chest Surgery / v.43, no.3, 2010 , pp. 280-284 More about this Journal
Abstract
Background: The postoperative management following lung transplantation has dramatically improved in the recent decade. However, some complications still remain as troublesome problems. We retrospectively reviewed the gastrointestinal complications and their management after lung transplantation. Material and Method: We performed a retrospective review of the medical records of 25 cases in 23 patients who underwent lung and heart-lung transplantations from July 1996 to March 2009. The definition of gastrointestinal complication was the gastrointestinal tract-related disease that occurred after lung transplantation. There were eight postoperative deaths (within postoperative 30 days) that were excluded from the analysis. Result: Twenty three gastrointestinal complications occurred in 11 (64.7%) of the 17 cases. The median follow-up period was 6.9 months (range: 2 months to 111 months), and chronic gastritis (23.5%, 4 of 17 cases) was the most common complication. Severe, prolonged (more than 2 weeks) diarrhea occurred in 3 cases. Three patients had gastric ulcer with one case requiring gastric primary closure for gastric ulcer perforation. This patient had gastric bleeding due to recurrent gastric ulcer 2 months after laparotomy. Cytomegalovirus gastritis and esophagitis occurred in 2 cases and 1 case, respectively, and esophageal ulcer occurred in 2 cases. There were esophageal strictures in 2 patients who underwent esophageal stent insertion. Other complications were one case each of ileus, early gastric cancer requiring endoscopic mucosal resection, gall bladder stone accompanied with jaundice, and pseudomembranous colitis. Conclusion: The incidence of gastrointestinal complication is relatively high in patients after they undergo lung transplantation. Since gastrointestinal complications can induce malnutrition, which might be related to considerable morbidity and mortality, close follow-up is necessary for the early detection and proper management of gastrointestinal complications.
Keywords
Lung transplantation; Complication; Gastrointestinal disease;
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1 Gilljam M, Chaparro C, Tullis E, Chan C, Keshavjee S, Hutcheon M. GI complications after lung transplantation in patients with cystic fibrosis. Chest 2003;123:37-41   DOI   ScienceOn
2 Hoekstra HJ, Hawkins K, de Boer WJ, Rottier K, van der Bij W. Gastrointestinal complications in lung transplant survivors that require surgical intervention. Br J Surg 2001;88:433-8   DOI   PUBMED   ScienceOn
3 Niklasson A, Strid H, Simren M, Engstrom CP. Bjornsson E. Prevalence of gastrointestinal symptoms in patients with chronic obstructive pulmonary disease. Eur J Gastroenterol Hepatol 2008;20:335-41   DOI   ScienceOn
4 Trulock EP, Edwards LB, Taylor DO, Boucek MM, Keck BM, Hertz MI. The registry of the international society for heart and lung transplantation: twenty-first official adult lung and heart-lung transplant report--2004. J Heart Lung Transplant 2004;23:804-15   DOI   ScienceOn
5 Lubetkin EI, Lipson DA, Palevsky HI, et al. GI complications after orthotopic lung transplantation. Am J Gastroenterol 1996;91:2382-90   PUBMED
6 King BJ, Iyer H, Leidi AA, Carby MR. Gastroesophageal reflux in bronchiolitis obliterans syndrome: a new perspective. J Heart Lung Transplant 2009;28:870-5   DOI   ScienceOn
7 Cholongitas E, Pipili C, Dasenaki M, Goudras S. Are upper gastrointestinal symptoms associated with exacerbations of COPD? Int J Clin Pract 2008;62:967   DOI   ScienceOn
8 Paul S, Escareno CE, Clancy K, Jaklitsch MT, Bueno R, Lautz DB. Gastrointestinal complications after lung transplantation. J Heart Lung Transplant 2009;28:475-9   DOI   ScienceOn
9 Anile M, Venuta F, Diso D, et al. Malignancies following lung transplantation. Transplant Proc 2007;39:1983-4   DOI   ScienceOn
10 Jaksch P, Zweytick B, Kerschner H, et al. Cytomegalovirus prevention in high-risk lung transplant recipients: comparison of 3- vs 12-month valganciclovir therapy. J Heart Lung Transplant 2009;28:670-5   DOI   ScienceOn
11 Smith PC, Slaughter MS, Petty MG, Shumway SJ, Kshettry VR, Bolman RM 3rd. Abdominal complications after lung transplantation. J Heart Lung Transplant 1995;14:44-51   PUBMED