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Management of asymptomatic cholelithiasis for patients awaiting renal transplantation

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Abstract

Background

There is no consensus regarding the most appropriate management of asymptomatic cholelithiasis in patients awaiting renal transplantation. Cholecystectomy is considered before renal transplantation because of potential worsened complications from cholelithiasis with posttransplantation immunosuppression. This study reviewed the outcomes for operative and nonoperative management of asymptomatic cholelithiasis in patients awaiting renal transplantation.

Methods

A retrospective chart review of all patients who received renal transplant at the authors’ institution during the period 1994 to 2000 was completed. All patients underwent pretransplantation abdominal ultrasound.

Results

Of the 411 patients receiving renal transplants (242 men and 169 women with a mean age of 45.7 years), 32 had cholelithiasis at the pretransplantation workup (7.8%), and 35 had gallbladder abnormalities (8.5%): polyps, thickened wall, sludge, bile duct dilation. Before transplantation, 12 of the 32 patients (38%) with cholelithiasis underwent uncomplicated cholecystectomy. None of the remaining 19 patients with cholelithiasis required cholecystectomy after renal transplantation (mean follow-up period 6.2 years). Of the 35 patients with gallbladder abnormalities, 2 required post transplantation elective cholecystectomy.

Conclusions

No evidence was found for increased morbidity related to cholelithiasis or gallbladder abnormalities after renal transplantation. As in the general population, the risks associated with asymptomatic cholelithiasis do not appear to warrant prophylactic cholecystectomy for patients awaiting renal transplantation.

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References

  1. S Cao K Cox SS So W Berquist SP Lee WG Haigh (1997) ArticleTitlePotential effect of cyclosporin A in formation of cholesterol gallstones in pediatric liver transplant recipients Dig Dis Sci 42 1409–1415 Occurrence Handle10.1023/A:1018894005748 Occurrence Handle1:CAS:528:DyaK2sXlsFCqsbY%3D Occurrence Handle9246038

    Article  CAS  PubMed  Google Scholar 

  2. Curry, Jr, Joehl, RJ (2001) “Asymptomatic gallstones” In: Cameron, Jl (ed), Current surgical therapy, Mosby, Toronto, pp 428–431

  3. GD Friedman (1993) ArticleTitleNatural history of asymptomatic and symptomatic gallstones Am J Surg 165 399–404 Occurrence Handle1:STN:280:ByyB2czltFI%3D Occurrence Handle8480871

    CAS  PubMed  Google Scholar 

  4. WA Gracie DF Ransohoff (1982) ArticleTitleThe natural history of silent gallstones: the innocent gallstone is not a myth N Eng J Med 307 798–800 Occurrence Handle1:STN:280:Bi2B2s3hvFM%3D

    CAS  Google Scholar 

  5. SM Graham JL Flowers E Schweitzer ST Bartlett AL Imbembo (1995) ArticleTitleThe utility of prophylactic laparoscopic cholecystectomy in transplant candidates Am J Surg 169 44–48 Occurrence Handle10.1016/S0002-9610(99)80108-1 Occurrence Handle1:STN:280:ByqC3Mjns1Q%3D Occurrence Handle7817997

    Article  CAS  PubMed  Google Scholar 

  6. SM Greenstein S Katz S Sun D Glicklich R Schechner R Kutcher V Tellis (1997) ArticleTitlePrevalence of asymptomatic cholelithiasis and risk of acute cholecystitis after kidney transplantation Transplantation 63 1030–1032 Occurrence Handle10.1097/00007890-199704150-00023 Occurrence Handle1:STN:280:ByiB28nmtF0%3D Occurrence Handle9112361

    Article  CAS  PubMed  Google Scholar 

  7. D Hull SA Bartus G Perdrizet RT Schweizer (1994) ArticleTitleManagement of cholelithiasis in heart and kidney transplant patients: with review of laparoscopic cholecystectomy Conn Med 58 643–647 Occurrence Handle1:STN:280:ByqC3M3lsFA%3D Occurrence Handle7813210

    CAS  PubMed  Google Scholar 

  8. JA Lowell RJ Stratta RJ Taylor JS Bynon JL Larsen NL Nelson (1993) ArticleTitleCholelithiasis in pancreas and kidney transplant recipients with diabetes Surgery 114 858–863 Occurrence Handle1:STN:280:ByuD38vlslE%3D Occurrence Handle8211705

    CAS  PubMed  Google Scholar 

  9. WS Melvin DJ Meier EA Elkhammas GL Bumgardner EA Davies ML Henry R Pelletier RM Ferguson (1998) ArticleTitleProphylactic cholecystectomy is not indicated following renal transplantation Am J Surg 175 317–319 Occurrence Handle10.1016/S0002-9610(98)00009-9 Occurrence Handle1:STN:280:DyaK1c3islKisw%3D%3D Occurrence Handle9568660

    Article  CAS  PubMed  Google Scholar 

  10. CH Spes CE Angermann RW Beyer (1990) ArticleTitleIncreased incidence of cholelithiasis in heart transplant recipients receiving cyclosporine therapy J Heart Transplant 9 404–407 Occurrence Handle1:STN:280:By%2BA2snisVc%3D Occurrence Handle2398436

    CAS  PubMed  Google Scholar 

  11. TB Steck MR Costanzo-Nordin A Keshavarzian (1991) ArticleTitlePrevalence and management of cholelithiasis in heart transplant patients J Heart Lung Transplant 10 1029–1032 Occurrence Handle1:STN:280:By2D1Mnkt1E%3D Occurrence Handle1756150

    CAS  PubMed  Google Scholar 

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Acknowledgments

The authors thank Abigail D’Sa and Sylvie Cornacchi of the Surgical Outcomes Research Committee (SOURCE) for providing assistance with data entry.

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Authors and Affiliations

  1. Department of Surgery, McMaster University, Hamilton, Ontario, Canada

    T. Jackson & D. W. Birch

  2. Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    D. Treleaven, D. Arlen, A. D’Sa & K. Lambert

Authors
  1. T. Jackson
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  2. D. Treleaven
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  3. D. Arlen
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  4. A. D’Sa
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  5. K. Lambert
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  6. D. W. Birch
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Corresponding author

Correspondence to D. W. Birch.

Additional information

Society of American Gastrointestinal and Endoscopic Surgeons(SAGES) 2004 oral presentation, program #2003

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Jackson, T., Treleaven, D., Arlen, D. et al. Management of asymptomatic cholelithiasis for patients awaiting renal transplantation. Surg Endosc 19, 510–513 (2005). https://doi.org/10.1007/s00464-004-8817-x

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  • DOI: https://doi.org/10.1007/s00464-004-8817-x

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