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World Journal of Surgery

, Volume 39, Issue 9, pp 2274–2281 | Cite as

Incidence and Risk Factors of Abdominal Complications After Lung Transplantation

  • Fabian GrassEmail author
  • Markus Schäfer
  • Alessandra Cristaudi
  • Carine Berutto
  • John-David Aubert
  • Michel Gonzalez
  • Nicolas Demartines
  • Hans-Beat Ris
  • Paola M. Soccal
  • Thorsten Krueger
Original Scientific Report

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.

Keywords

Diverticulitis Idiopathic Pulmonary Fibrosis Lung Transplantation Gastroparesis Pneumatosis Intestinalis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

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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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Fabian Grass
    • 1
    • 3
    Email author
  • Markus Schäfer
    • 1
  • Alessandra Cristaudi
    • 1
  • Carine Berutto
    • 2
  • John-David Aubert
    • 2
  • Michel Gonzalez
    • 3
  • Nicolas Demartines
    • 1
  • Hans-Beat Ris
    • 3
  • Paola M. Soccal
    • 4
  • Thorsten Krueger
    • 3
  1. 1.Department of Visceral SurgeryLausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV)LausanneSwitzerland
  2. 2.Department of PneumologyLausanne University Hospital (CHUV)LausanneSwitzerland
  3. 3.Department of Thoracic SurgeryLausanne University Hospital (CHUV)LausanneSwitzerland
  4. 4.Department of PneumologyGeneva University Hospitals (HUG)GenevaSwitzerland

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