Korean J Thorac Cardiovasc Surg.  2010 Jun;43(3):280-284. 10.5090/kjtcs.2010.43.3.280.

Gastrointestinal Complications after Lung Transplantation

• Haam SJ
• Paik HC
• Kim JH
• Lee DY
• Kim CW
• Kim JH

• KMID: 1455498
• DOI: http://doi.org/10.5090/kjtcs.2010.43.3.280

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.

Keyword

Lung transplantation; Complication; Gastrointestinal disease

MeSH Terms

Constriction, Pathologic
Cytomegalovirus
Diarrhea
Enterocolitis, Pseudomembranous
Esophagitis
Follow-Up Studies
Gastritis
Gastrointestinal Diseases
Heart-Lung Transplantation
Hemorrhage
Humans
Ileus
Incidence
Jaundice
Laparotomy
Lung
Lung Transplantation
Malnutrition
Medical Records
Retrospective Studies
Stents
Stomach Neoplasms
Stomach Ulcer
Ulcer
Urinary Bladder Calculi