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Colorectal Surgery After Kidney Transplantation: Characteristics of Early vs. Late Posttransplant Interventions

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The majority of colorectal complications after kidney transplantation reportedly occur <1 year of transplant. We aimed to identify differences in complications in the early and late posttransplant period.

Methods

We retrospectively reviewed kidney transplant recipients undergoing colorectal resection from 1 June 2000 to 1 June 2012 at a single institution, comparing patients by posttransplant year (<1 vs. >1 year). Measured outcomes included major complications, postoperative length of stay, perioperative mortality, reoperations, and readmissions.

Results

We identified 45 patients aged 31–77 (median 55). Gastrointestinal malignancy (31 %), diverticular disease (24 %), and ischemic colitis (16 %) were the most common indications for surgery. The early group (n = 9) had more cases of ischemic colitis (44 vs. 6 %, p = 0.01), emergent operations (100 vs. 33 %, p = 0.0003), blood transfusion (78 vs. 31 %, p = 0.02), longer length of stay (23.2 ± 12 vs. 11.7 ± 10 days, p = 0.02), and higher mortality rate (33 vs. 6 %, p = 0.05 compared to the late group (n = 36)). There were no significant differences in major complications, reoperations, or readmissions.

Conclusions

Kidney transplant recipients undergoing colorectal resection <1 year of transplant have a higher incidence of emergency surgery and ischemic colitis compared with those with >1 year posttransplant. Despite these findings, patients with grafts <1 year had a similar postoperative complication rate to patients with grafts >1 year.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St SE, MMC#195, Minneapolis, MN, 55455, USA

    Janet T. Lee, Genevieve B. Melton, Robert D. Madoff & Mary R. Kwaan

  2. Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA

    Ty B. Dunn

  3. Department of Surgery, Hennepin County Medical Center, Minneapolis, MN, USA

    Anne-Marie Sirany

Authors
  1. Janet T. Lee
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  2. Ty B. Dunn
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  3. Anne-Marie Sirany
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  4. Genevieve B. Melton
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  5. Robert D. Madoff
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  6. Mary R. Kwaan
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Correspondence to Janet T. Lee.

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Lee, J.T., Dunn, T.B., Sirany, AM. et al. Colorectal Surgery After Kidney Transplantation: Characteristics of Early vs. Late Posttransplant Interventions. J Gastrointest Surg 18, 1299–1305 (2014). https://doi.org/10.1007/s11605-014-2534-0

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  • DOI: https://doi.org/10.1007/s11605-014-2534-0

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