The spectrum of colonic complications in a lung transplant population.
BACKGROUND
Abdominal complications are recognized as a common complication of solid organ transplantation. These complications can range from gastritis with minor morbidity to viscus perforation and death. This study addresses specifically colonic complications in lung transplant patients to highlight their high incidence and significant morbidity and mortality in this population.


METHODS
Data was obtained from a prospectively gathered database on 210 patients who underwent isolated lung transplantation between February 1, 1990, and July 10, 2000 at the Cleveland Clinic Foundation. Chronic diarrhea without a specific colonic lesion and infectious diarrheas except for CMV disease was excluded from the analysis.


RESULTS
Twenty-seven of the 210 transplant recipients (13 percent) developed a colonic complication. The sex distribution of complications was 14 males and 13 females. The colonic complications noted were diverticulitis (9), CMV colitis (5), colon cancer/precancerous polyps (4), post transplant lymphoproliferative disorder (4), megacolon (4), colon rupture (2). One patient had concurrent CMV colitis and diverticulitis. Documented perforations occurred in seven patients and surgical resection was required in 11 patients. Of the 27 patients, 10 died and nine of the deaths were directly attributable to the colonic complication.


CONCLUSIONS
Colonic complications are common post lung transplant and result in excessive morbidity and mortality in this population. Strategies to reduce this risk should be put in place in lung transplant centers.
Maurer
J R
JR
Section of Lung Transplantation, Dept. Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, USA. maurerj@ccf.org
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003092:Colitis / Q000209:etiology; D003108:Colonic Diseases / Q000209:etiology*; D003110:Colonic Neoplasms / Q000209:etiology; D003111:Colonic Polyps / Q000209:etiology; D003586:Cytomegalovirus Infections / Q000209:etiology; D004238:Diverticulitis / Q000209:etiology; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D008531:Megacolon / Q000209:etiology; D008875:Middle Aged; D012422:Rupture, Spontaneous