title: Incidence and Risk Factors of Abdominal Complications After Lung Transplantation.
abstract: BACKGROUND
  Due to the underlying diseases and the need for immunosuppression, patients after lung transplantation are particularly at risk for gastrointestinal (GI) complications that may negatively influence long-term outcome. The present study assessed the incidences and impact of GI complications after lung transplantation and aimed to identify risk factors.
  
  
  METHODS
  Retrospective analysis of all 227 consecutively performed single- and double-lung transplantations at the University hospitals of Lausanne and Geneva was performed between January 1993 and December 2010. Logistic regressions were used to test the effect of potentially influencing variables on the binary outcomes overall, severe, and surgery-requiring complications, followed by a multiple logistic regression model.
  
  
  RESULTS
  Final analysis included 205 patients for the purpose of the present study, and 22 patients were excluded due to re-transplantation, multiorgan transplantation, or incomplete datasets. GI complications were observed in 127 patients (62%). Gastro-esophageal reflux disease was the most commonly observed complication (22.9%), followed by inflammatory or infectious colitis (20.5%) and gastroparesis (10.7%). Major GI complications (Dindo/Clavien III-V) were observed in 83 (40.5%) patients and were fatal in 4 patients (2.0%). Multivariate analysis identified double-lung transplantation (p = 0.012) and early (1993-1998) transplantation period (p = 0.008) as independent risk factors for developing major GI complications. Forty-three (21%) patients required surgery such as colectomy, cholecystectomy, and fundoplication in 6.8, 6.3, and 3.9% of the patients, respectively. Multivariate analysis identified Charlson comorbidity index of ≥3 as an independent risk factor for developing GI complications requiring surgery (p = 0.015).
  
  
  CONCLUSIONS
  GI complications after lung transplantation are common. Outcome was rather encouraging in the setting of our transplant center.
authors.affiliation: Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Bugnon 46, 1011, Lausanne, Switzerland, fabian.grass@chuv.ch.
authors.forename: Fabian
authors.initials: F
authors.lastname: Grass
authors.forename: Markus
authors.initials: M
authors.lastname: Schäfer
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cristaudi
authors.forename: Carine
authors.initials: C
authors.lastname: Berutto
authors.forename: John-David
authors.initials: JD
authors.lastname: Aubert
authors.forename: Michel
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
authors.forename: Hans-Beat
authors.initials: HB
authors.lastname: Ris
authors.forename: Paola M
authors.initials: PM
authors.lastname: Soccal
authors.forename: Thorsten
authors.initials: T
authors.lastname: Krueger
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D018589:Gastroparesis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology