Prevalence of diverticulosis and incidence of bowel perforation after kidney transplantation in patients with polycystic kidney disease |
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Authors: | E Domínguez Fernández K H Albrecht U Heemann M Kohnle J Erhard F Stöblen F W Eigler |
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Institution: | (1) Department of General Surgery, University Medical School Essen, D-45 122 Essen, Germany Fax: + 49 201 723 5946, DE;(2) Department of Nephrology, University Medical School Essen, D-45 122 Essen, Germany, DE;(3) Department of Radiology, University Medical School Essen, D-45 122 Essen, Germany, DE |
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Abstract: | Sigmoid perforation due to diverticulitis is a life-threatening complication in the postoperative course of allogenic kidney
transplantation. The incidence of diverticulosis is especially high among patients with autosomal dominant polycystic kidney
disease (ADPKD). Thus, those who undergo allogenic kidney transplantation represent a high-risk group. The aim of this study
was to evaluate the prevalence of diverticulosis in ADPKD patients awaiting renal transplantation and the incidence of bowel
perforation following allogenic kidney transplantation due to ADPKD. Within the group of 1128 patients who underwent transplantation
between January 1974 and January 1990, there were 46 patients (4.07 %) whose indication for transplantation was ADPKD. There
was one patient who developed a sigmoid perforation under postoperative immunosuppression. Surgical treatment was a discontinuity
resection of the sigmoid (Hartmann's procedure). The postoperative course was favorable, the bowel continuity has already
been restored, and the graft is still functioning well. Fifteen of the 28 (53.5 %) ADPKD patients awaiting transplantation
had colon diverticulosis (12 male and 3 female patients). No case of bowel perforation has thus far been observed in 15 of
these patients who have undergone transplantation. A sigmoid resection was necessary in one patient due to diverticulitis
without perforation. We did not find a higher prevalence of diverticulosis in patients with ADPKD, nor did we see a higher
incidence of sigmoid perforation during post-transplant immunosuppression in this study.
Received: 30 January 1997 Received after revision: 15 July 1997 Accepted: 19 August 1997 |
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Keywords: | Kidney transplantation diverticulosis polycystic kidney disease Polycystic kidney disease diverticulosis kidney transplantation Diverticulosis polycystic kidney disease kidney transplantation |
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