Intraabdominal complications after lung transplantation.
BACKGROUND
Because more lung transplant recipients survive the perioperative period, nonpulmonary complications become a major source of morbidity and mortality. Of these, intraabdominal complications are of particular concern because of the potential need for surgical intervention. So appropriate management of these complications becomes paramount.


METHODS
We retrospectively reviewed 229 lung transplant recipients in a university medical center, between January 1997 and December 2004 developed in forty-seven patients. Abdominal complications. Detailed reviews of these patients' hospital charts were performed. Complications were categorized as early or late depending on if they occurred within 30 days of transplantation or later. The primary outcomes variable studied was mortality.


RESULTS
Fifty-three surgical consultations for abdominal symptoms were requested in these 47 patients. Twenty-two of the 47 patients (47%) with intraabdominal complications required 24 operative interventions. Overall 5-year survival was substantially worse in patients with intraabdominal complications (34%) than in those without (62%, p=0.01). There was no marked difference in the 30-day mortality for patients experiencing early (27%, 4 of 15) versus late (24%, 9 of 38) complications. Mortality in patients with intraabdominal complications was lower among those treated operatively (n=2, 9%) compared with those treated nonoperatively (n=11, 44%, p=0.02).


CONCLUSIONS
Mortality for patients with intraabdominal complications is high after lung transplantation. Operative intervention is well tolerated and associated with lower mortality. A high index of suspicion and timely operative intervention are necessary for the treatment of intraabdominal complications in lung transplant recipients.
Miller
C Brock
CB
Department of Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA.
Malaisrie
S Chris
SC
Patel
Jateen
J
Garrity
Edward
E
Vigneswaran
Wickii T
WT
Gamelli
Richard L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D003550:Cystic Fibrosis / Q000601:surgery; D004066:Digestive System Diseases / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies