title: Intestinal Perforation in Renal Transplant Recipients: A Single Center Experience of 2123 Recipients.
abstract: OBJECTIVE
  Intestinal perforation remains a clinical challenge and potentially lethal complication in renal transplant recipients. Immunosuppression not only places the patient at risk for intestinal perforation but also masks classic clinical symptoms and signs of acute abdominal pain, leading to delayed diagnosis and proper treatment. The aim of our study is to present the experience of our center on the treatment of intestinal perforation in renal transplant recipients.
  
  
  METHODS
  This study reported 11 patients (0.52%) with intestinal perforation among a group of 2123 patients who received renal transplants in the Transplantation Unit at Laikon General Hospital in Athens, Greece from 1983 to August 2015.
  
  
  RESULTS
  One patient died from septic shock before any surgery, and 3 patients died during the early postoperative period, resulting in a morality rate of 36.3%. All patients who died had a functioning graft. From the patients who were discharged, the mean follow-up was 16 months (range, 4-32 months).
  
  
  CONCLUSIONS
  Intestinal perforation after renal transplant is a major and potentially lethal complication. Clinical presentation is usually equivocal, and the transplant surgeon should be highly suspicious when treating a renal transplant recipient with acute abdominal pain, even in cases without other predisposing factors (diverticulitis, ischemic colitis, and so forth), so that this condition could be investigated and unmasked.
authors.affiliation: From the Transplantation Unit, Laikon General Hospital, Athens, Greece.
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Kakavia
authors.forename: Demetrios
authors.initials: D
authors.lastname: Moris
authors.forename: Elli
authors.initials: E
authors.lastname: Karatza
authors.forename: John
authors.initials: J
authors.lastname: Bokos
authors.forename: Spiridon
authors.initials: S
authors.lastname: Vernadakis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Barlas
authors.forename: Georgios
authors.initials: G
authors.lastname: Sotirchos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Diles
authors.forename: Spyridon
authors.initials: S
authors.lastname: Drakopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Zavos
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D059787:Acute Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006115:Greece / Q000453:epidemiology; D017052:Hospital Mortality; D006769:Hospitals, General; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007416:Intestinal Perforation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents