Nonobstructing Colonic Dilatation and Colon Perforations Following Renal Transplantation

Baburao Koneru, Rick Selby, Daniel P. O'hair, Andreas G. Tzakis, Thomas R. Hakala, Thomas E. Starzl

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Nonobstructing colonic dilatation has not been commonly reported following renal transplantation, and colon perforations carry a high morbidity and mortality in this population. During a 7-year period, nonobstructing colonic dilatation developed in 13 adults 1 to 13 days after renal transplantation. Twelve (92%) of the 13 had poorly functioning allografts. Five (83%) of the 6 with and 2 (29%) of the 7 without colonoscopy had resolution of nonobstructing colonic dilatation. Of the seven right-sided colon perforations during this period, six were associated with nonobstructing colonic dilatation. An additional 4 patients had diverticular perforations in the left colon. Of a total of 11 patients with colon perforation, 7 had surgery within 24 hours of the perforation and 6 (86%) of these survived. Only 1 (25%) of the 4 having surgery more than 24 hours later survived. Six of the survivors retained functioning allografts. Nonobstructing colonic dilatation seems to be a potential complication of poor graft function after renal transplantation, and colonoscopy is effective in its treatment. In patients with colon perforations, early surgery and reduced immunosuppression are essential in decreasing mortality.

Original languageEnglish (US)
Pages (from-to)610-613
Number of pages4
JournalArchives of Surgery
Volume125
Issue number5
DOIs
StatePublished - May 1990
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

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