Acute appendicitis in organ transplantation patients: a report of two cases and a literature review.
BACKGROUND
Abdominal surgery on patients with previous organ transplantation, especially in the early postoperative period, is a challenging problem. Due to high risk of complications in transplant patients, we usually tend to treat such patients more conservatively rather compared to the more aggressive attitude in diagnosis and surgery of non-transplant patients. Delayed diagnosis, delayed surgery, and high morbidity and mortality are more common in transplant patients with GI disease. While appendicitis is one of the most common surgical diseases, with an estimated lifetime risk of 8.6% for males and 6.7% for females, there are relatively few reports of appendicitis in solid organ transplant recipients, and the condition has rarely been reported after liver transplantation.


METHODS
We have performed surgery on 2 cases of presumed acute appendicitis among 75 cases of kidney and liver transplantation in our series in the last 10 years. Laparoscopic technique was used for exploration of presumed acute appendicitis with atypical clinical and image presentation in a deceased donor liver transplantation (DDLT) and a deceased donor kidney transplantation (DDKT).


CONCLUSIONS
Acute appendicitis in both patients was highly suspected preoperatively in computed tomography, and early exploration with laparoscopic technique prompted early diagnosis and treatment, with excellent surgical outcomes.
Department of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-I, Taiwan.
Chang Kuo
CK
Wei
Department of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-I, Taiwan.
Chun Min
CM
Chang
Department of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-I, Taiwan.
Cheng Hung
CH
Lee
Department of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-I, Taiwan.
Jian Han
JH
Chen
Department of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-I, Taiwan.
Wen Yao
WY
Yin
D000208:Acute Disease; D001064:Appendicitis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D012307:Risk Factors