Gastrointestinal complications in liver transplant recipients: MITOS study.
BACKGROUND
Liver transplant recipients frequently suffer gastrointestinal (GI) complications but their prevalence and their influence on quality of life remain unknown.


OBJECTIVE
The objective of this study was to asses the prevalence, impact on quality of life, and management of GI complications in liver transplant recipients.


METHODS
This was an epidemiologic, cross-sectional, multicenter study. Four hundred seventeen liver recipients were recruited in 14 centers. A questionnaire was filled for every patient.


RESULTS
The median age of the patients was 55 years. The median time since transplantation was 4.1 +/- 4 years. Whereas 19.2% presented some GI disease before transplantation, 49.4% showed this type of complication after transplantation. Diarrhea was the most prevalent GI complication, and anorexia was the GI disorder that affected patients daily activities the most frequently. GI complications were more frequent among female patients, subjects with pretransplantation hiatal hernia, and those readmitted after transplantation. Of the patients with GI complications, 70.9% received pharmacological treatment (89.7% with gastric protectors). Immunosuppressive therapy was also modified because of GI complications. Immunosuppressive drug dose was reduced in 18.1%, transiently stopped in 3.4%, and definitively stopped in 3.4% of cases. The drug most frequently changed was mycophenolate mofetil: dose reduction, 23.6%; transient withdrawal, 5.7%; and definitive withdrawal, 6.6%.


CONCLUSIONS
The prevalence of GI complications in the liver transplant population was approximately 50%. GI complications showed a significant impact on the quality of life of the patients. They were related to female gender, to pretransplantation GI pathology, and posttransplantation hospital admission. These complications were frequently managed with pharmacological therapy or with changes in immunosuppressive therapy.
Herrero
J I
JI
Clínica Universitaria, St Cruz de Tenerife, Spain. iherrero@unav.es
Benlloch
S
S
Bernardos
A
A
Bilbao
I
I
Castells
L
L
Castroagudin
J F
JF
González
L
L
Irastorza
I
I
Navasa
M
M
Otero
A
A
Pons
J A
JA
Rimola
A
A
Suárez
F
F
Casanovas
T
T
Otero
E
E
Rodríguez
M
M
Serrano
T
T
Otero
S
S
López
I
I
Miras
M
M
Prieto
M
M
D000328:Adult; D000368:Aged; D002102:Cadaver; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D016027:Heart Transplantation / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007297:Inpatients / Q000706:statistics & numerical data; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D016040:Lung Transplantation / Q000009:adverse effects / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D013030:Spain; D014019:Tissue Donors
D007166:Immunosuppressive Agents