Acute colonic pseudo-obstruction (Ogilvie's syndrome) after renal transplantation.
BACKGROUND
Acute colonic pseudo-obstruction (Ogilvie's syndrome) in the immunosuppressed patient is associated with increased morbidity and mortality. Renal transplant recipients possess several comorbidities that increase the risk of acute pseudo-obstruction of the colon. The aims of this study were to present our experience with this syndrome and to evaluate the potentiating factors in these patients. A review of the literature for pseudo-obstruction following renal transplantation is presented.


METHODS
Seven patients who developed Ogilvie's syndrome were identified in a retrospective review of 550 kidney-only transplants. Pretransplant data, potential risk factors, presentation, management, and outcome details were retrieved. The medical literature was reviewed using Medline.


RESULTS
Seventy-eight patients with Ogilvie's syndrome in the early posttransplant period have been reported. The associated morbidity and mortality was heightened in this immunocompromised population. Obese transplant recipients (body mass index >30 kg/m2) were at significantly increased risk for developing this syndrome.


CONCLUSIONS
A broad armamentarium of treatment options is available, but the key to successful resolution lies in early recognition.
Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
K J
KJ
O'Malley
S M
SM
Flechner
A
A
Kapoor
R A
RA
Rhodes
C S
CS
Modlin
D A
DA
Goldfarb
A C
AC
Novick
D003112:Colonic Pseudo-Obstruction / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors