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Incidence and Risk Factors of Abdominal Complications After Lung Transplantation

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Abstract

Background

Due to the underlying diseases and the need for immunosuppression, patients after lung transplantation are particularly at risk for gastrointestinal (GI) complications that may negatively influence long-term outcome. The present study assessed the incidences and impact of GI complications after lung transplantation and aimed to identify risk factors.

Methods

Retrospective analysis of all 227 consecutively performed single- and double-lung transplantations at the University hospitals of Lausanne and Geneva was performed between January 1993 and December 2010. Logistic regressions were used to test the effect of potentially influencing variables on the binary outcomes overall, severe, and surgery-requiring complications, followed by a multiple logistic regression model.

Results

Final analysis included 205 patients for the purpose of the present study, and 22 patients were excluded due to re-transplantation, multiorgan transplantation, or incomplete datasets. GI complications were observed in 127 patients (62 %). Gastro-esophageal reflux disease was the most commonly observed complication (22.9 %), followed by inflammatory or infectious colitis (20.5 %) and gastroparesis (10.7 %). Major GI complications (Dindo/Clavien III–V) were observed in 83 (40.5 %) patients and were fatal in 4 patients (2.0 %). Multivariate analysis identified double-lung transplantation (p = 0.012) and early (1993–1998) transplantation period (p = 0.008) as independent risk factors for developing major GI complications. Forty-three (21 %) patients required surgery such as colectomy, cholecystectomy, and fundoplication in 6.8, 6.3, and 3.9 % of the patients, respectively. Multivariate analysis identified Charlson comorbidity index of ≥3 as an independent risk factor for developing GI complications requiring surgery (p = 0.015).

Conclusion

GI complications after lung transplantation are common. Outcome was rather encouraging in the setting of our transplant center.

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Acknowledgment

The authors thank Pierluigi Ballabeni for his valuable help in statistical analyses.

Conflict of interest

No conflict of interest or funding source to declare.

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Authors and Affiliations

  1. Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Bugnon 46, 1011, Lausanne, Switzerland

    Fabian Grass, Markus Schäfer, Alessandra Cristaudi & Nicolas Demartines

  2. Department of Pneumology, Lausanne University Hospital (CHUV), Lausanne, Switzerland

    Carine Berutto & John-David Aubert

  3. Department of Thoracic Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland

    Fabian Grass, Michel Gonzalez, Hans-Beat Ris & Thorsten Krueger

  4. Department of Pneumology, Geneva University Hospitals (HUG), Geneva, Switzerland

    Paola M. Soccal

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  1. Fabian Grass
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  2. Markus Schäfer
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Correspondence to Fabian Grass.

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Grass, F., Schäfer, M., Cristaudi, A. et al. Incidence and Risk Factors of Abdominal Complications After Lung Transplantation. World J Surg 39, 2274–2281 (2015). https://doi.org/10.1007/s00268-015-3098-1

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  • DOI: https://doi.org/10.1007/s00268-015-3098-1

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